Visual Diagnosis in Emergency Medicine| Volume 43, ISSUE 4, P712-713, October 2012

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Acute Flank Pain with Intra-abdominal Cystic Mass

      A 36-year-old man presented to the Emergency Department with sudden onset of left flank pain, difficulty voiding, and fever with chills for 1 day. Physical examination revealed a distended abdomen with left flank knocking tenderness. Plain radiography of the abdomen revealed a huge intra-abdominal mass (Figure 1A ). Computed tomography scan of the abdomen revealed a giant hydronephrosis of the left kidney (Figure 2). Emergent percutaneous nephrostomy was done and approximately 5870 mL of turbid urine was drained. Follow-up plain radiography of the abdomen 5 days later demonstrated the disappearance of the intra-abdominal cystic mass, and the calcifications had become gathered (Figure 1B).
      Figure thumbnail gr1
      Figure 1(A) Plain radiography of the abdomen shows a huge intra-abdominal mass (arrows). (B) Plain radiography of the abdomen reveals the disappearance of the mass.
      Figure thumbnail gr2
      Figure 2Computed tomography of the abdomen reveals a giant hydronephrosis of left kidney.
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