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This x-ray was taken on a 20-year-old woman who had presented 4 hours earlier with epigastric pain and a soft abdomen. The symptoms improved with Maalox but she returned because of persistent vomiting.

View the image taken (Figure 1) and consider what your diagnosis would be.

20-year-old woman with abdominal pain and vomiting

Nahum Kovalski, BSc, MDCM

Clinical Researcher at TEREM Emergency Services
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