Abnormal Gastrointestinal Imaging in a Patient With Dyspepsia Caleb Shin, 1 Milena Gould Suarez, 2 and Mimi C. Tan 2 1 College of Natural Sciences, University of Texas, Austin, and 2 Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, Texas Question: A 47-year-old woman with a history of previous alcohol abuse presented with 3 weeks of sharp, burning abdominal pain located in the epigas- tric and left upper quad- rant areas. The pain was intermittent but worse after meals and associated with nausea. She was afebrile and physical ex- amination revealed epigas- tric abdominal tenderness to palpitation without peritoneal signs. Labora- tory tests were notable for normal white blood count, liver function tests, and lipase level. A computed tomography (CT) scan revealed a hypodense structure abutting the second/third portion of duodenum with adjacent inflammatory changes (Figure A, circled), sigmoid diverticulosis, and no evidence of cholelithiasis. Small bowel follow-through revealed duodenal diverticula (Figure B, arrows) near the location of the structure seen on the CT scan. What is the most likely diagnosis? See the Gastroenterology web site (www.gastrojournal.org) for more information on submitting your favorite image to Clinical Challenges and Images in GI. Conflicts of interest The authors disclose no conflicts. © 2018 by the AGA Institute 0016-5085/$36.00 https://doi.org/10.1053/j.gastro.2018.01.049 Gastroenterology 2018;155:e13–e14 ELECTRONIC CLINICAL CHALLENGES AND IMAGES IN GI