Case Details -
A lady in her 70s was brought to the emergency department after experiencing significant abdominal pain in the left lower quadrant for three days. It was associated with constipation and numerous bouts of vomiting. She has been a smoker since she was 15 years old, averaging 5-10 cigarettes a day. She has a medical history of chronic obstructive pulmonary disease and has been taking medication for 7 months with poor compliance. She had a history of hemorrhoidectomy surgery around 2 years ago. She has given birth eight times, with two abortions. On examination, her heart rate was 122 beats per minute, and her blood pressure was 110/80 mm of Hg. The abdomen was soft and tender in the lower left quadrant, with no guarding or rigidity. Femoral and inguinal hernias were not detectable on palpation. On chest auscultation, both sides had decreased air entry.