An unusual case of abdominal pains

Description

A 55-year-old African American man presented to the emergency room with 3 days of new-onset right-sided flank and abdominal pains. His abdominal pains were dull in nature, constant, moderate in severity (approximately 6 out of 10) and radiated to his back and right flank regions. There were no aggravating factors but the patient reported temporary relief with over-the-counter acetaminophen. The pains were associated with mild nausea and vomiting but he denied diarrhoea, constipation, weight loss, fevers or other associated symptoms. His only known medical history was hypertension, controlled with lisinopril. Surgical, social and family history were unremarkable. Other than abdominal pains, a complete review of systems was negative. His blood pressure was 117/78 mm Hg and his pulse was 82 bpm. His physical examination revealed right flank and right lower quadrant abdominal pain without rebound or guarding.

He underwent an abdominal CT scan which showed a 5.2 cmx4.2 cm hypodensed solid right...

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