Elderly Woman With Abdominal Pain

A 91-year-old woman presented to our emergency department with abdominal pain for 3 days. Her vital signs were normal and a physical examination showed localized tenderness in the epigastrium. Laboratory tests revealed leukocytosis and elevated liver function test results. After she complained of right lower quadrant abdominal pain, right lower quadrant tenderness and a positive psoas sign were noted. A surgeon was consulted because of the impression of acute appendicitis, and intravenous contrast–enhanced computed tomography (CT) of her abdomen was performed.

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