A 32yo woman has severe right sided abdominal pain radiating into the groin which has lasted for 3h. She is writhering in pain. She has no abdominal signs. What is the most likely cause of her abdominal pain?
a. Appendicitis
b. Ruptured ectopic pregnancy
c. Salpingitis
d. Ureteric colic
e. Strangulated hernia
answer: D
Pain from upper ureteral stones tends to radiate to the flank and lumbar areas.
Midureteral calculi cause pain that radiates anteriorly and caudally. This midureteral pain in particular can easily mimic appendicitis on the right or acute diverticulitis on the left.
Distal ureteral stones cause pain that tends to radiate into the groin or testicle in the male or labia majora in the female.
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