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A man, aged 49, Japanese, referred to me by Dr. Tanaka, Dec. 29, 1926, had had beriberi in 1918 and typhoid in 1925; otherwise the history was negative. The day before he was admitted to the hospital, he noticed a distention of the abdomen followed by nausea in about two hours. Five hours later, he began to complain of pain in the epigastrium, which soon became so severe that a physician was called. He was given an enema and one-fourth grain (16 mg.) of morphine, which was repeated in one hour. He slept well that night, but the pain was again severe the next morning. On the evening of the second day, the patient was brought to the hospital.
Physical examination was negative except for the abdomen, which was not distended, but extremely rigid and tender. The upper part of the abdomen was very tender, especially under the right
Holden WB. VOLVULUS OF THE GALLBLADDER. JAMA. 1927;88(14):1077–1078. doi:10.1001/jama.1927.92680400033012b
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