Author: Raymond Jabola, DO
Co Author #1: Ahmed Aly Elghawy, DO
Co Author #2: Keyur Desai, MD
Co Author #3: Kenneth Chavin, MD, PHD
Senior Editor: Christian Fulmer, DO
Editor: Cleo Stafford, II, MD, MS
Patient Presentation:
Right lower abdominal pain for the last twelve months
History:
An 18-year-old female college track and field sprinter first presented with right lower abdominal pain for the last twelve months. The pain started while performing twisting
abdominal oblique exercises. She noted a sharp pain with a bulge in the right lower abdomen. She rated the pain as a nine out of ten, exacerbated by lifting weights, abdominal core
exercises, and sprinting. Symptoms were alleviated with rest.
Physical Exam:
Temperature: 37.1 degrees Celsius, Heart Rate: 73, Blood Pressure: 111/64, Respiratory Rate 16, Oxygen Saturation on Room Air: 99%, Body Mass Index: 22.41
General: well appearing, comfortable
HEENT: atraumatic, moist mucous membranes
Abdomen: tenderness to the right lower abdomen with deep palpation. Pain with crunches and leg lifts at rectus muscle. Visible mass along right lower/medial abdomen with positional change
Extremities: gait intact, 5/5 strength in all extremities
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