Review Question - QID 216714

A 40-year-old woman presents to the emergency department with diffuse abdominal pain. She states that she has had this pain on and off for 5 years and that it causes her anxiety. The pain is rated as a 9/10 in severity and is non-radiating. There is no recent history of trauma. A review of her medical records shows 12 prior visits to the emergency department for the same concern, with multiple prior abdominal CT scans with no remarkable findings. She has been unemployed for over a year and has a history of childhood sexual abuse. She had a normal colonoscopy and upper endoscopy last month. The patient’s temperature is 98.7°F (37.1°C), blood pressure is 120/80 mmHg, pulse is 70/min, and respirations are 16/min. On physical exam, she is tearful and endorses mild tenderness to palpation in all abdominal quadrants. Pelvic exam reveals a normal cervix with no discharge, no cervical motion tenderness, and no adnexal tenderness. Which of the following is the most likely diagnosis?