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A 72-year-old woman presented with intermittent abdominal pain and elevated ferritin levels. Despite extensive imaging, the cause remained undiagnosed after two years, highlighting diagnostic challenges.

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Area of Science:

  • Gastroenterology
  • Diagnostic Imaging
  • Hepatology

Background:

  • A 72-year-old female patient with no significant medical history presented with a two-month history of mild, intermittent abdominal pain.
  • Her only chronic medication was diazepam for a sleep disorder, and she had a prior history of facial photodermatitis.

Observation:

  • Initial physical examination, blood counts, and metabolic panels were normal, with the exception of a slightly elevated ferritin level (265 ng/mL).
  • Abdominal ultrasound, multiphasic contrast-enhanced CT, and liver MRI were performed, but no definitive diagnosis was established.
  • Acetaminophen was prescribed for symptomatic relief, but the abdominal pain persisted.

Findings:

  • Two years later, repeat laboratory tests and imaging studies showed similar findings, with no notable changes or new developments.
  • The persistent, unexplained abdominal pain and elevated ferritin levels in the absence of other symptoms posed a diagnostic challenge.

Implications:

  • This case underscores the importance of considering less common etiologies for unexplained abdominal pain and elevated ferritin.
  • Further investigation may be warranted in similar cases to avoid diagnostic delays and ensure appropriate patient management.
  • The diagnostic odyssey highlights potential limitations in current imaging and laboratory protocols for certain gastrointestinal presentations.