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JAMA Surgery Clinical Challenge
May 2015

Woman With Abdominal Pain

Author Affiliations
  • 1Department of Surgery, Saint Agnes Hospital, Baltimore, Maryland
JAMA Surg. 2015;150(5):487-488. doi:10.1001/jamasurg.2014.1851

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.

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