Periumbilical pain for four days.
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CT confirms free intraperitoneal fluid, predominantly within the pelvis in the recto uterine pouch. Focal fat stranding and trace fluid in the right paracolic gutter, below the caecum and appendix, is consistent with segmental omental infarction.
The appendix is normal in appearance. There is mild periportal oedema within the left lobe of the liver, of uncertain significance (? overhydration). No focal liver mass.
The remainder of the solid organ and hollow viscus structures of the abdomen and pelvis are within normal limits. There is minimal dependant collapse at the lung bases, with a small right pleural effusion.
Rudimentary ribs at L1.No destructive bony abnormality.
Appearances are consistent with RLQ segmental omental infarction, with free fluid within the pelvis. The appendix is normal in appearance.