Medical history Male patient, 40 years old, seeks care in a Belo Horizonte hospital complaining of nausea and a few episodes of vomiting, as well as mild pain in the right lower abdomen for about 1 week. Denies similar presentations in the past. On physical examination, the patient is in good general condition, afebrile, being recognized palpable and painful mass in the right lower abdomen without signs of peritoneal irritation. Complete blood count was requested - which revealed mild leukocytosis with deviation – in addition to a contrasted abdominal CT scan. Image 1: Abdominal computerized tomographyImage 2: Abdominal computerized tomography Question:Based on clinical data and images, which is the most likely diagnosis and the best work-up? Mesenteric lymphadenitis, exploratory laparotomy is indicated. Spigelian hernia, surgical reduction must be programmed. Crohn's disease, CT-guided biopsy should be performed. Hyperplastic appendicitis, the patient should be admitted into the hospital for antibiotic therapy. Time is Up! Time's up
