The Leading Diagnosis -- A 23-year-old black woman presented to the emergency department with diffuse, colicky abdominal pain of 1 hour's duration

doi:10.1056/NEJMcps062653

Volume 357:2389-2393		December 6, 2007		Number 23

The Leading Diagnosis — A 23-year-old black woman presented to the emergency department with diffuse, colicky abdominal pain of 1 hour's duration

Thomas E. Baudendistel, M.D., Amy K. Haase, M.D., and Faith Fitzgerald, M.D.

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In this Journal feature, information about a real patient ispresented in stages (boldface type) to an expert clinician,who responds to the information, sharing his or her reasoningwith the reader (regular type). The authors' commentary follows.

A 23-year-old black woman presented to the emergency departmentwith diffuse, colicky abdominal pain of 1 hour's duration. Thepain was followed by nausea and episodes of bilious vomitingand did not radiate or change with the patient's position. Shedid not report fever, chills, diarrhea, hematochezia, or melena.

The differential diagnosis of acute abdominal pain in youngadults is broad and . . . [Full Text of this Article]

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Source Information

From the Department of Medicine, California Pacific Medical Center, San Francisco (T.E.B., A.K.H.); and the Department of Medicine, University of California at Davis, Sacramento (F.F.).

Address reprint requests to Dr. Baudendistel at California Pacific Medical Center, 2351 Clay St., Suite 380, San Francisco, CA 94115 or at baudent@sutterhealth.org.