A 54 old female presented to the emergency department with history of epigastric discomfort that progressed to sudden severe generalized abdominal pain associated with anorexia, nausea and two episodes of vomiting later in the day. The patient had not open bowel or passed flatus that day. On examination, she was afebrile, normotensive and normal heart rate. The palpation of the abdomen revealed a distended, guard and board like rigid belly. The rectal exam was normal.

Patient Data

Age: 54 year old
Gender: Female