Case 37031

Presentation of CaseA fifty-five-year-old woman entered the hospital because of vomiting and right-upper-quadrant abdominal pain.The patient stated that for about five years before admission she had attacks of right-upper-quadrant pain, at times associated with nausea and vomiting. Her doctor presumed this to have been gall-bladder disease, but no x-ray films had been taken. Her health was fairly good until five days prior to entry, when the right-upper-quadrant pain became more severe than usual and pain was also present in the epigastrium. This persisted until the day before entry, and on two occasions was so severe that the patient . . .