Question: A 53-year-old man presented to the emergency department with 2 hours of upper abdominal pain. Vital signs were unremarkable. He had no underlying disease, but had taken some unknown Chinese herbs for 1 year. Physical examination revealed palpation tenderness over the upper gastric and the right abdominal area associated with rebounding pain. Pertinent laboratory values revealed a white blood cell count of 13,270/mm3. The emergency physician then arranged an abdominal computed tomography (CT).