Intense Abdominal Pain After a Night of Partying

Marie-Lee Simard, MD; Alexandre Lafleur, MD, MSc


August 10, 2023

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A 24-year-old man presents to the emergency department (ED) with sudden right lower quadrant abdominal pain, nausea, and vomiting. Before the onset of these symptoms, he was feeling well. The pain is constant and intense, limiting his movements. It radiates to the right flank but not to the groin. He says he does not have fever, weight loss, diarrhea, bloody stool, urinary symptoms, or gross hematuria. Thorough questioning reveals no recent trauma, extreme physical activity, infectious contacts, travel, or unprotected sexual intercourse.

His past medical history and a detailed family history are both unremarkable. He has no allergies and does not take any medications regularly. He specifically denies taking nonsteroidal anti-inflammatory drugs and acetaminophen. He does not smoke, but he drinks alcohol occasionally. He mentions using recreational intranasal cocaine. His last exposure was 4 days ago during what he describes as a "wild" party.


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