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A woman with abdominal swelling
  1. So Sakamoto1,
  2. Yasuhiro Suyama2,
  3. Manabu Sugita1
  1. 1 Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Tokyo, Japan
  2. 2 Rheumatology, JR Tokyo General Hospital, Shibuya-ku, Japan
  1. Correspondence to Dr So Sakamoto, Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima-ku, Japan; sounet1980{at}

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Clinical introduction

A previously healthy 74-year-old woman presented to the emergency department with a 2-day history of abdominal wall protrusion in the lower left side of her abdomen. Nine days earlier, she had experienced a burning pain at the same location. After being prescribed an oral non-steroidal anti-inflammatory drug (NSAID) for suspected left-side ureteral stone, she had applied an NSAID patch to the area. This did not alleviate the sensation. Physical examination revealed asymmetric abdominal swelling that became more prominent when standing (figure 1). No pulse …

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  • Contributors SS: conception and design. SS and MS: acquisition of data and patient management. YS: interpretation of data. Furthermore, SS and YS have participated in writing the manuscript. All authors have read and approved the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Ethics approval The institutional Review Board at Juntendo Nerima Hospital.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Patient consent for publication Obtained.