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A 64-year-old female presented to the ED with severe abdominal pain. Initially it was suspected to be spontaneous aortic rupture or dissection. Contrasted CT imaging studies did not identify aneurysm and dissection, but did identify a concerning, confounding, and curious collection of fluid in the upper right quadrant. Angiography imaging was obtained and identified the origin as the collecting duct of the right kidney. The patient was admitted to the medical service. She was then evaluated by the urology service and they identified this