A 74 year-old Portuguese speaking man with history of hypertension, hyperlipidemia, depression, non-insulin-dependent diabetes, presented to the emergency department with one week of left flank pain. The pain was gradual in onset and cramping in quality. The pain was constant and worse since beginning last week, approaching 10/10 in severity. It was located over the left flank and radiated toward the left abdomen and groin. The patient stated his symptoms began while cooking dinner. He had been working in his home vineyard and vegetable garden all day…

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