Endocrine Case Report: Right Lower Quadrant Pain


Our latest emergency department case report from Brady Pregerson, MD, features a woman in her mids 30s presenting with 2 days of gradually worsening suprapubic and right lower quadrant pain. Can you determine the correct diagnosis?


A female in her 30’s with no significant PMH other than obesity presents to the emergency department with 2 days of gradually worsening suprapubic and RLQ pain that radiates to the back and is associated with 5 episodes of non-bloody vomiting but no fever, dysuria, diarrhea, or discharge. She denies any other complaints or recent unprotected sex.


Vital signs are all normal. The abdomen is soft with diffuse lower abdominal tenderness, which is worse on the right and guarding as well as right CVA tenderness.


  • WBC = 11, other blood work negative
  • UA small blood, otherwise negative
  • A pelvic ultrasound shows a 3.5 cm simple right ovarian cyst with good flow and no free fluid
  • A CT scan is shown below

CT scan of abdomen

What is the additional diagnosis?

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