MSFinals-6401
A 50-year-old woman arrives at the Emergency Department complaining of cramp-like abdominal pain, nausea, and vomiting that started 4 hours ago. She describes the pain as intermittent and has experienced similar pain before, but not as severe as this time. The patient has a history of chronic obstructive pulmonary disease, which is well-controlled with inhalers, and has been a smoker for 25 pack years.
Her vital signs are heart rate 110/min, respiratory rate 20/min, blood pressure 130/84 mmHg, temperature 38.6ºC, and oxygen saturation of 99% on room air. Upon examination, the patient appears very ill and sweaty, with some yellowing of the eyes. Palpation of the abdomen reveals tenderness in the right upper quadrant.
What is the most likely cause of the patient’s symptoms?