A 34-year-old man presented to the emergency department after a low velocity motor vehicle accident. He complained of severe periumbilical pain, emesis and an episode of syncope 7 hours prior at arriving to the hospital. Case presentation The patient described his abdominal pain as constant, radiating to the right lower quadrant and associated with nausea and vomiting. His last bowel movement was prior to his presentation to the hospital. The patient described a history of intermittent, colicky periumbilical pain for the past three months.
He denied any previous surgical history. He had no history of any tobacco, alcohol or recreational drug use. Physical examination Afebrile Blood pressure of 132/76 Pulse rate 68 Abdominal examination No signs of abdominal trauma or previous surgical scars. He had a tender palpable mass in the right lower quadrant with involuntary guarding and rebound…
