Elderly Woman With Abdominal Pain

An 87-year-old woman presented to the emergency department, complaining of worsening abdominal pain that began 2 to 3 weeks before and was associated with nausea, emesis, and constipation. Physical examination revealed a distended abdomen with guarding and rebound tenderness in the left lower quadrant. In addition, there was a 1-cm pink nodular lesion in the umbilicus (Figures 1 and 2). Computed tomography (CT) of the abdomen and pelvis with contrast showed metastatic lesions throughout the abdomen (Figures 3 and 4).

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