Patient History: A 77-year-old man presented as an emergency with the severe right inguinal pain of sudden onset radiating caudally and voiding difficulties. Due to the pain, the patient was unable to lie still. The history consisted of 35 pack-years of cigarette smoking and moderate alcohol consumption but was otherwise unremarkable. Current medication clopidogrel and Tamsulosin.
Body mass index was 32 and on physical examination a mass was palpable in the middle lower abdomen. Urinalysis show microhaematuria but no sign of infection. Laboratory Findings: Ultrasound show a fluid-filled non-echogenic structure in the middle lower abdomen and mild dilation of both renal pelvicalyceal systems, more pronounced on the right side. A plain abdominal x-ray showed calcifications in the lower pelvis (image attached) A transurethral catheter was inserted but drained only 30 ml of urine and did…
