Abstract

A 57-year-old woman with no known systemic disease presented to the emergency department with abdominal pain and vomiting for 3 days. She was well-oriented, with a body temperature of 36.5°C, blood pressure of 133/80 mm Hg, and tachycardia of 118 beats/min. On abdominal palpation, she had tenderness, with no signs of peritoneal irritation. Right-sided costovertebral angle tenderness was elicited. Laboratory data revealed neutrophil-predominant leukocytosis (13,140/μL), thrombocytopenia (10,000/μL), and hyperglycemia (460 mg/dL), representing a new diagnosis of diabetes at the emergency department.

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