case_images: PMC6436364_01
case_images: (a) CT abdomen of patient 1 showing a 6 cm pancreatic head/uncinate mass (indicated by an arrow). (b) Whole body image of octreotide scan, anterior view, demonstrating intense uptake of octreotide in the corresponding pancreatic head and uncinate process (indicated by an arrow), with no additional site of pathologic octreotide intake to suggest regional or distant metastases.
case_images: BMRI2019-9721781.001.jpg
case_images: PMC6436364_01_BMRI2019-9721781.001.jpg
case_images: fig1
case_images: Air in the sigmoid colon mesentery and a solid pancreatic head mass were noted on CT of the abdomen/pelvis (Figure 1(a)). Short-acting octreotide was added based on a positive octreotide scan (Figure 1(b)).
case_images: PMC6436364_02
case_images: PMC6436364_03
case_images: CT abdomen/pelvis of patient 3. Representative CT showing numerous tubular structures within the liver filled with gas extending to the subcapsular liver surface, felt to be secondary to a perforated diverticulum in the sigmoid colon and secondary abscess.
case_images: BMRI2019-9721781.002.jpg
case_images: PMC6436364_03_BMRI2019-9721781.002.jpg
case_images: fig2
case_images: CT abdomen/pelvis showed a small pelvic abscess adjacent to the sigmoid colon, representing a secondary abscess from a perforated diverticulum (Figure 2).
case_images: 24-hour urinary free cortisol levels from 2008 to 2014 of patient 3. Episodes of perforation indicated by *, the first episode occurred while on pasireotide and the second one during colonoscopy.
case_images: BMRI2019-9721781.003.jpg
case_images: PMC6436364_03_BMRI2019-9721781.003.jpg
case_images: fig3
case_images: Cushing's disease and a residual microadenoma on MRI sella that was not amenable to surgery given its proximity to the optic chiasm. Cabergoline was initiated and her 24-hour UFC levels normalized for seven months, following which levels were intermittently elevated (Figure 3).
case_images: PMC6436364_04
case_images: PMC6436364_05
case_images: PMC6436364_06