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Sudden-onset flank pain
  1. Karl Chopra1,
  2. Thomas Adams1,
  3. Ashley Matthies2
  1. 1 Homerton University Hospital, London, UK
  2. 2 Emergency Department, Homerton University Hospital NHS Foundation Trust, London, UK
  1. Correspondence to Dr Karl Chopra, Homerton University Hospital, London E9 6SR, UK; karl.chopra1{at}

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Clinical Introduction

A 36-year-old woman presented to the ED with sudden-onset right flank and iliac fossa pain that began 3 hours prior to arrival, associated with vomiting and diarrhoea. She denied dysuria or fever. Her observations were within normal range. Examination of her abdomen revealed right flank tenderness (figure 1). A point-of-care ultrasound was obtained.

Figure 1

Right upper quadrant view showing the right kidney and Morrison’s pouch.


What is the likely diagnosis?

  1. Ruptured ectopic pregnancy.

  2. Renal haematoma.

  3. Ruptured ureteral calyx.

  4. Ruptured appendix.

Answer: C

The ultrasound shows moderate hydronephrosis …

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  • Contributors All authors made substantive contributions to final 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.

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

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