The Instant Diagnosis 5






A 65-year-old woman with a long history of atrial fibrillation presents to the emergency department with a history of sudden onset of severe abdominal pain. Following the onset of pain, she vomited once and had a large bowel movement. No flatus has been passed since that time. Physical examination reveals a mildly distended abdomen, which is diffusely tender, although peritoneal signs are absent. Ten years ago, she underwent an abdominal hysterectomy. The most likely diagnosis in this patient would be:

(A) acute cholecystitis
(B) perforated duodenal ulcer
(C) acute diverticulitis
(D) acute embolic mesenteric ischemia
(EI small bowel obstruction secondary to adhesions
See the diagnosis and a little discussion

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