Colicky Epigastric and Right Upper Quadrant Pain

Abstract

A woman in her 50s presented to our emergency department with a 3-hour history of sudden epigastric and right upper quadrant pain. She did not report any previous abdominal surgery. The colicky pain did not migrate during that period and occurred in paroxysms at 9-to 10-minute intervals. The patient was afebrile and had no nausea or vomiting. Physical examination revealed mild tachycardia (96/min) and moderate abdominal distension without signs of peritonism; the bowel sounds were hyperactive. Careful examination ruled out incarcerated hernias in the groin, femoral triangle, and obturator foramen. Blood analysis results showed mild leukocytosis (total white blood cell count, 10.