Abdominal mass

A 29 year old man was admitted as an emergency in the general surgical ward with one day history of right iliac fossa pain. He also had past history of on and off right iliac fossa pain.

On admission he was apyrexial; blood pressure and pulse were normal. Abdominal examination showed non-distended abdomen and tenderness in the right iliac fossa.

An ill defined mass was palpable in the right iliac fossa. Bowel sounds were normal. Laboratory investigations showed slightly raised blood urea and serum creatinine.

Other blood counts and inflammatory markers were normal. An ultrasound scan and ointravenous ureterogram (IVU) identified a congenital anomaly. Subsequently, a computed tomography scan was arranged (fig 1). He had a mercapto acetyl triglyceride renogram, which showed split renal function of 35% on the right side.