A 70-year-old woman presented to the emergency department with sharp abdominal pain in the left lower quadrant during a seven-hour period. She reported an episode of vomiting; however, her bowel function was normal, and she had not had a high temperature while at home. Her medical history included hypertension, for which she was being treated, and type 2 diabetes mellitus controlled with oral therapy. Examination Temperature: 39.6°C Abdominal examination: Tender to deep palpation, with mild resistance.
There was no rebound tenderness, and her bowel sounds were barely audible. Digital rectal examination revealed stools without blood. The abdominal radiograph was normal and no substantial free intra-abdominal gas was observed. Laboratory investigations White blood cell count: Normal C-reactive protein level: Normal Total bilirubin: 1.39 mg/dL Creatinine: 1.27 mg/dL Aspartate…
