Introduction An 80-year-old woman presented to the emergency department with severe right-sided abdominal pain that had started after her last meal. Physical examination revealed fever (38.6°C) and rebound tenderness in the right upper quadrant of the abdomen. The laboratory studies showed a leucocyte count of 11.3×109/L (normal, 3.7–8.0×109/L) and a C-reactive protein level of 2.34 mg/dL (normal, <0.03 mg/dL). There were no other significant findings. A CT scan of the abdomen with contrast revealed retroperitoneal air around a duodenal diverticulum (figures 1 and 2).
Question What is the most likely diagnosis and the cause underlying the condition?
- abdominal pain
- abdominal surgery
- diagnostic and therapeutic endoscopy
- diverticular disease
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Contributors HS drafted and revised the manuscript. AF reviewed and revised the manuscript. AK reviewed and revised the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Parental/gaurdian consent obtained.
Provenance and peer review Not commissioned; externally peer reviewed.