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A woman in her 60s presented to the emergency department with a 1-day history of abdominal pain. She reported acute onset of pain that woke her up from sleep, was crampy in nature, and was localized to the right upper quadrant. She denied any nausea or vomiting and there was no association with eating. She reported similar pain over the previous month but not to the current severity. There was no history of fevers/chills, diarrhea, melena, or hematochezia. She had never had a colonoscopy. Her medical history included hypertension and gastroesophageal reflux. She had no smoking or alcohol history. Her only operations in the past were nononcologic, nongastrointestinal procedures.
Beteck B, Haddad A, Cunningham SC. Woman With Abdominal Pain. JAMA Surg. 2015;150(5):487-488. doi:10.1001/jamasurg.2014.1851