Abstract
A 65-year-old woman presented to the emergency department with a 2-day history of intermittent but aggravating lower abdominal pain with nausea. She denied having a fever or vomiting. She had previously undergone surgeries for appendicitis, ectopic pregnancy, and vaginal prolapse. She was lucid and had stable vital signs. Physical examination revealed diffuse lower abdominal pain with peritoneal signs and decreased bowel sounds. Pelvic ultrasonography indicated thickening of the small bowel (Figure 1).
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