A 34-year-old, 18-week-pregnant woman presented with one week of severe periumbilical pain. Two months previously she presented to another hospital with similar but less severe pain. She had had no prior abdominal surgery. At the time of the first admission she underwent laparoscopic lysis of an adhesion between the umbilicus and the right colon according to the report. She had transient relief of symptoms at that time.
Laboratory values and vital signs were normal. Physical exam was remarkable for a bulge at the superior aspect of the umbilicus associated with marked local periumbilical tenderness. The remainder of the abdominal examination was unremarkable. OB/GYN examination demonstrated no GYN pathology. The patient was taken for abdominal ultrasound. A fluid-filled supraumbilical cavity was seen.
Link to this frame from your Personal Thumbnails page?