Anatomy clinical correlates Quiz: Ace Your Exams

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A 43-year-old woman comes to the office because of blood in her urine. The patient reports intermittent painless hematuria associated with mild to moderate left lumbar pain and nausea for the last three months. She does not have dysuria, urinary frequency, or urinary urgency. Past medical history is significant for major depression, and the patient reports that she has lost a lot of weight over the past few months. Family history is unremarkable. Vitals are within normal limits. Physical examination shows a nontender, nondistended abdomen. Lungs and cardiovascular examination are within normal limits. Urinalysis shows 15–20 Er/Hpf and no proteinuria. An abdominal CT is shown below. Which of the following is the most likely cause of this patient’s presentation?  

An axial C T image of abdomen shows organs including liver, stomach, kidneys, and spleen. Vertebra is visible posteriorly. Stomach has air/fluid levels.
Reproduced from Radiopedia

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