Case 41452

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Abstract
Presentation of Case First admission. A sixty-two-year-old Lithuanianborn painter was admitted to the hospital because of pain in the right upper quadrant of the abdomen.Ten months before entry the patient began to pass watery stools, which contained bright-red blood; after a few months he became constipated, but the melena continued. Three days before admission marked the onset of pain in the right upper quadrant of the abdomen radiating to the right shoulder posteriorly and made worse by moving, breathing and coughing. An x-ray film of the chest revealed slight elevation of the right leaf of the diaphragm and limitation . . .

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