Description

A 78-year-old woman with a history of peptic ulcer and recent use of non-steroidal anti-inflammatory medication presented to the emergency department with a 3-day history of progressively worsening abdominal distention and pain. She had been seen at the same emergency department on the day before, and was treated symptomatically with intravenous fluids and promethazine and discharged with a presumptive diagnosis of gastroenteritis.

The patient was haemodynamically unstable and improved after resuscitation in the emergency department. …