25 thoughts on “Photo Quiz- Rani

  1. Gastroscopic view. Little new & lot of dark blood are seen.
    Unable to see any typical varicose veins, ulcer, Mallory-Weiss tear or any obvious neoplastic lesion in this single view. Some more pictures might help.
    Seelan

    Liked by 1 person

    • Thinking further:-
      It could be a gastroscopic view of Refluxing mainly dark blood ( with a little fresh blood) from stomach into oesophagus.

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  2. The commonest cause of Haematemesis is a bleeding peptic ulcer. This may be the diagnosis.

    However I see Polypoid masses at 4 O’clock, 5 O’clock and 7 O’clock. Differential diagnosis :

    1. Ca esophagus

    2. Bleeding polyp.

    As Seelan alluded to more pictures are needed.

    Thanks Rani. Good puzzle.

    Nisantha

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    • Clues;

      I have not posted an easy obvious image for the ” Photo Quiz”

      Please , my advice is , let the image ( what you see ) guide you to the solution, rather than allowing your assumptions to supersede the thinking process?

      Liked by 1 person

  3. My Medicine Brain site is dead !
    But I will take your advice on ‘what you see guide you to the solution.
    Perhaps it might come to me in a dream !!!
    eagleD

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  4. Image “B” looks like that the area involved is Pyloric antrum. This may be a case of Bleeding GASTRIC ANTRAL ULCER or GASTRIC LYMPHOMA

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  5. Must be a fungal infection- if it took 8 months to treat .
    So, my first guess from the top of the naturalist head- ‘exotic mushroom’ which is a fruiting body of the fungus anyway , is closer to the truth ?
    Anyway, I am also going to bed now- it is almost bed time for this old lady – had a busy day today – bird watching ( Sandhill Cranes ) driving around for 4 hrs and had a nice relaxed time, not worrying about Medical quiz stuff !!
    Good Night – Keep Dreaming — eagleD

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    • EGD Image clues/H/o

      Opening at one end – cardiac Sphincter
      Distal end of Oesophagus
      Black regular ,LOGITUDINAL leisions,( too clear cut blackish demarcations to be mistaken for old blood)

      Diagnosis- Oesophageal Necrosis (rare condition)

      D/D.
      Oesophageal Melanocytosis,coal dust deposition,,Malignant Melanoma,

      I don’t think it is necessary ,for a “Podyan” like myself ,need to post details about Oesophageal necrosis to my “learned mates”

      Dear all. , Participation is the “Nobel gesture”, Thanks

      Winning the trophy for guessing the quiz is something.

      But Participation is” EVERYTHING”

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  6. Thank you Rani for the REAL Brain Teaser Quiz , you sure got full marks for ” Participation is Everything ” , and Sam for the Web to get us all trapped in this wonderful Sam Spider Web .

    Leave it to the Down Under Encyclopedia to get the old Septugenerian neurons to work over time !!!!
    I have given away my old Grays Anatomy from the Block Days – so , have to rely on Dr. Google for Anatomy Lessons .
    Well done Rani- eaglemd.

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  7. Dear Rani,
    Thanks for stimulating my necrotic brain which might improve in 8 months time!!
    I understand that this is a rare condition & only about 80 odd cases have been reported in 40 years.
    Do you subscribe to the New England Journal of medicine. Where do you find time to read all these? After you published the answer, I can see it in the journal.

    Main thing is : some of us tried.
    I am wondering why the cardiac sphincter is open in both pictures. May be there was a small hiatus hernia?

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  8. Dear Rani
    Thank you 🌺🌺🌺for your medical brain teaser. That was very interesting and brain challenging. I am glad πŸ™‚πŸ™‚πŸ™‚that you have stated that Participation is everything because I am participating but never getting it correct πŸ™€πŸ™€πŸ™€πŸ™€πŸ™€πŸ™€πŸ™€πŸ™€.Praxy

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    • Ya Praxy- you are right on the money !
      Like a lottery tikt- if you dont buy one, how can you ever hope to win even a dime , never mind the jack pot !
      I just love Rani’s Brain Teasers – and thanks to Sam, we all have fun playing the Quiz game- even if I lose half the time .
      My brain is not what it used to be- like what Seelan says – undergone a bit of necrosis .
      But, I am not going to take any treatment for it !!!!

      Rani – you must be having time hanging on your hands to go through all this exotic stuff-
      I barely have time to brush my teeth !!!!
      Anyway -I went to the Dentist y’day for the routine check and he said ‘ mary I give you the prize for the best teeth for anyone over 60- never mind over 70 ‘ !!
      I must be doing something right !
      oh- oh- I am going off the track here – Bye everyone – have a good night – eagleD

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  9. Dear Rani,
    your clinical teasers, to my septuagenarian brain,
    do a big favour by teasing neurones, a wakeup run
    yet for being on an unarousable, very long vacation
    Fail to answer, task to them seems a heavy burden

    Ariya responding, lying among warm sand dunes
    in Mount Lavinia beach

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