Case 33-1967

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Abstract
Presentation of Case First admission. A sixty-six-year-old woman was admitted to the hospital because of pain in the abdomen.For many years she had had severe rheumatoid arthritis involving all the extremities; the sole therapy had been aspirin. Two days before entry diffuse abdominal pain developed suddenly, with subsequent localization in the right lower quadrant. On the following day she vomited several times.The patient was an emaciated woman with rheumatoid deformities of the hands and feet and flexor contractures of the hips, knees and elbows. The heart was not enlarged; a Grade 2 precordial midsystolic murmur was audible. . . .

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