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Answers to Epilogue questions: An unusual case of abdominal distension with constipation

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  1. Figure 1 shows an abnormal bowel gas distribution with central paucity, and the impression that bowel is displaced into the upper abdomen.

  2. Figure 2 shows a large fluid-filled mass occupying most of the central abdomen but not extending above the liver (arrowed) into the subphrenic space. This was initially erroneously reported as gross ascites.

  3. Figure 3 shows a large septated cystic abdominal mass, with no discernible cyst wall. Its maximum dimensions are 18.5×10.5×23.5 cm (transverse × antero-posterior × cranio-caudal diameters).

  4. The consensus in this case was that it was likely to be a congenital mesenteric cyst. He underwent a diagnostic laparoscopy, which confirmed the presence of a cyst arising from the sigmoid colon and its mesentery. An 800 mL of clear sterile fluid was drained and a dissection …

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