Exenatide and Rare Adverse Events

We received 1610 responses, from 85 countries, for this medical mystery.Sixty-two percent of respondents were physicians in practice, 21% were physicians in training, and 12% were medical students.Of the respondents, 65% identified some type of diaphragmatic hernia on the radiograph, which revealed a retrocardiac gastric shadow (Panel A).Specifically, 46% suggested a hiatal hernia, and 13% proposed another type of diaphragmatic defect such as Bochdalek's or Morgagni's hernia; 6% correctly identified gastric volvulus.The remaining 35% of respondents suggested a variety of diagnoses, including aortic aneurysm, Boerhaave's syndrome, Zenker's diverticulum, thymoma, pulmonary abscess, and achalasia.