BACKGROUND
This 52-year-old woman presents with acute onset of diffuse, colicky abdominal pain and nonprojectile vomiting. She has passed no flatus in the last 2 days. On examination, the abdomen is distended. The patient has diffuse tenderness to palpation, greatest in the right lower quadrant, but no rebound or guarding. Her bowel sounds are present but hypoactive. Heel tap and Murphy signs are negative, and no fluid thrill is elicited. The patient is afebrile. Her cardiovascular and respiratory systems are normal.
What is the diagnosis?
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Hint
This is a surgical emergency. The condition can appear with pain referred to the knee.
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Author:
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Ali Nawaz Khan, MBBS, FRCP, FRCS, FRCR, Lecturer, Department of Diagnostic Radiology, Faculty of Medicine, University of Manchester, and Prabhakar Rajiah, MD, FRCR, Registrar, Department of Radiology, North Manchester General Hospital NHS Trust, UK
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North Manchester General Hospital, Manchester, UK
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eMedicine Editor:
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Sat Sharma, MD
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Associate Professor, University of Manitoba, Department of Medicine, Division of Pulmonary Medicine
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eMedicine Case
