RT Journal A1 Lord C, Ozgediz D, Cohen M T1 IMage of the month JF Archives of Surgery JO Archives of Surgery YR 2009 FD January 19 VO 144 IS 1 SP 87 OP 87 DO 10.1001/archsurg.2008.533-a UL http://dx.doi.org/10.1001/archsurg.2008.533-a AB A 50-year-old, male North African immigrant presented with 3 hours of abdominal pain, initially diffuse, then migrating to the lower abdomen, with greater right-sided pain. He had nausea and anorexia but no fevers and no abnormal bowel movements. He had been admitted a month prior with several days of abdominal pain, vomiting, and melena. At that time, esophagogastroduodenoscopy revealed nonbleeding duodenal varices and abdominal ultrasonography was within normal limits. He was discharged home with treatment for Helicobacter pyloriand scheduled for a capsule study but was lost to follow-up.