CHIEF COMPLAINT: Left flank pain and unable to urinate. HISTORY: The patient is a 46-year-old female who presented to the emergency room with left flank pain and difficulty urinating. Details are in the history and physical. She does have a vague history of a bruised left kidney in a motor vehicle accident. She feels much better today. I was consulted by Dr. X. MEDICATIONS: Ritalin 50 a day. ALLERGIES: To penicillin. PAST MEDICAL HISTORY: ADHD. SOCIAL HISTORY: No smoking, alcohol, or drug abuse. PHYSICAL EXAMINATION: She is awake, alert, and quite comfortable. Abdomen is benign. She points to her left flank, where she was feeling the pain. DIAGNOSTIC DATA: Her CAT scan showed a focal ileus in left upper quadrant, but no thickening, no obstruction, no free air, normal appendix, and no kidney stones. LABORATORY WORK: Showed white count 6200, hematocrit 44.7. Liver function tests and amylase were normal. Urinalysis 3+ bacteria. IMPRESSION: 1. Left flank pain, question etiology. 2. No evidence of surgical pathology. 3. Rule out urinary tract infection. PLAN: 1. No further intervention from my point of view. 2. Agree with discharge and followup as an outpatient. Further intervention will depend on how she does clinically. She fully understood and agreed.