Woman With Abdominal Pain

Abstract

A 24-year-old woman presented with a history of intermittent right upper quadrant abdominal pain for months. She had recently completed a course of antibiotic treatment for a positive urinalysis, although she denied dysuria or urgency. On examination, she was afebrile and had mild right upper abdominal tenderness. Laboratory studies demonstrated a WBC count of 13 × 103/μL, normal kidney function, and urinalysis with 3 to 10 leukocytes, more than 4 bacteria, and negative nitrites. The emergency physician performed a bedside ultrasound (Figure 1) and confirmed the diagnosis with computed tomography (Figure 2).