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.