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To the editor:On 5th March 2013,a 50-year-old male patient developed an intermittent dull pain of his right lower abdomen without any other symptoms.He performed crunches 2 days ago.Abdominal radiograph was unremarkable.The abdominal dull pain continued but it could be tolerated.On 12th March,2013,the patient developed increasingly server abdominal pain when he moved a heavy table,and it was intensified when pressed.The patient then came to our clinic for further consultation.His medical history included chronic atrial fibrillation and transient cerebral ischemia 2 years before.He was maintained on warfarin therapy since then.Physical examination revealed a moderate tendess with fullness mass over the right lower abdominal quadrant.