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Mrs A, a 46-year-old Indigenous woman, presented to a clinic in Callao, near Lima, Peru. Her husband accompanied her and did much of the talking. Reticent and with flat affect, she complained of abdominal pain. She worked as a street vendor, had three children, and no previous surgeries. Mrs A said she did not feel depressed but found financial insecurity and crowded living conditions stressful. Physical examination was notable for diffuse abdominal pain on palpation, with no rebound or guarding, and mild pain over her lower left ribs.
