TY - JOUR T1 - Eighty-nine-year-old woman with abdominal pain and vomiting JF - Emergency Medicine Journal JO - Emerg Med J SP - 576 LP - 576 DO - 10.1136/emermed-2017-207359 VL - 35 IS - 9 AU - Joerg Schramm AU - Andreas Rickenbacher AU - Dagmar Iris Keller Y1 - 2018/09/01 UR - http://emj.bmj.com/content/35/9/576.abstract N2 - Clinical introduction An 89-year-old female patient presented to the ED with mild abdominal pain and a history of vomiting for 3 days. Because of dementia, further history was unclear. Vital signs were normal. Clinical examination revealed mild abdominal pain without defence or signs of peritonism. Bowel sounds were normal. Lab results showed a white cell count of 16x109/L, otherwise normal. There was no episode of vomiting during the ED consultation. A supine AXR was performed (figure 1).Figure 1 Supine AXR.What is the diagnosis?Foreign bodyGallstone ileusColon obstructionIntestinal volvulus ER -