Intended for healthcare professionals

Endgames Spot Diagnosis

Abdominal pain in a 24 year old woman

BMJ 2016; 355 doi: (Published 13 October 2016) Cite this as: BMJ 2016;355:i5264
  1. Joseph Dalby Sinnott, core surgical trainee1,
  2. David C Howlett, consultant radiologist2
  1. 1Department of Surgery, East Sussex Hospitals NHS Trust, Eastbourne, UK
  2. 2Department of Radiology, East Sussex Hospitals NHS Trust, Eastbourne, UK
  1. Correspondence to: J D Sinnott j.d.sinnott{at}

A 24 year old woman was admitted to the surgical assessment unit with a tender, distended abdomen. She mentioned increasingly frequent bloody diarrhoea for the past week. Clinically she was dehydrated and pyrexial (38.6°C). She was also tachycardic (124 bpm) and had a raised white cell count (14×109/L). A supine abdominal radiograph was obtained (fig 1 …

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