A 80-year-old she patient presented with nausea, vomiting and abdominal pain. Her past medical history was diabetes mellitus and hypertension.

On abdominal examination, Murphy’s sign was positive. An abdominal radiograph was performed (Figure 1). The patient declined surgery, which is the usual treatment, and was treated with antibiotics.

Author information: Cemil Kavalci, Emergency Department; Atakan Sezer, General Surgery Department; Eylem Sezenler, Emergency Department; Mütasım Sungun, Emergency Department; Trakya University Medical Faculty, Edirne, Turkey

Correspondence: Cemil Kavalci, Emergency Department, Trakya University Faculty of Medicine, 22030, Edirne, Turkey. Fax: +90 (0)284 2352338; email: cemkavalci@yahoo.com