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Case 304.

María Luque-Cabal¹, Verónica Álvarez-Guisasola¹, Sofía Rizzo-Raza¹

¹From the Department of Radiology, Hospital Universitario Río Hortega, C/ Dulzaina s/n, Valladolid 47010, Spain.

|March 21, 2022

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A 72-year-old woman experienced persistent abdominal pain. Initial tests showed elevated ferritin, but imaging revealed no diagnosis, necessitating further investigation over two years.

Area of Science:

Gastroenterology
Radiology
Internal Medicine

Background:

A 72-year-old woman presented with a two-month history of intermittent abdominal pain.
Medical history was unremarkable apart from facial photodermatitis; diazepam was the only chronic medication.
Initial laboratory tests revealed a slightly elevated ferritin level (265 ng/mL).

Purpose of the Study:

To investigate the cause of persistent abdominal pain in a patient with elevated ferritin levels.
To evaluate the utility of serial imaging studies in diagnosing unexplained abdominal discomfort.
To document the diagnostic challenges and progression of a case with initially inconclusive findings.

Main Methods:

Abdominal ultrasonography (US) was performed.

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Multiphasic contrast-enhanced computed tomography (CT) and liver magnetic resonance imaging (MRI) were utilized.

Laboratory tests and imaging studies were repeated two years later for comparison.

Main Results:

Initial physical examination, blood count, and metabolic panels were normal.
Abdominal US, CT, and MRI did not yield a definitive diagnosis.
Repeated investigations after two years showed similar findings with no significant changes.

Conclusions:

The initial presentation and investigations did not establish a clear diagnosis for the patient's abdominal pain.
Persistent symptoms and elevated ferritin warranted further, albeit inconclusive, diagnostic efforts over a two-year period.
The case highlights the challenges in diagnosing unexplained abdominal pain even with advanced imaging techniques.