Abdominal Pain and Hypotension in a 70-Year-Old Woman

Abstract

A 70-year-old woman with hypertension, atrial fibrillation, congestive heart failure, and gallstones had 3 days of nausea, vomiting, and abdominal pain. Abdominal computed tomography showed a thickened gallbladder wall with intraluminal air adherent to the duodenum and a gallstone in the middle ileum with proximal bowel distension. What is the diagnosis and what would you do next?