There are several reasons for this outcome, as follows: (i) the disease is very rare, and both doctors and radiologists lack awareness; (ii) there are no reliable clinical signs or laboratory findings [5] (approximately 1/2 of patients had a slightly increased C-reactive protein level and white blood cell count, and 1/3 had an increased D-dimer level in our study); and (iii) some patients have other diseases of acute abdomen simultaneously, such as urinary calculi, intestinal obstruction, and gallstone/cholecystitis. This evidence concerns the gene CRP and gallstones.