A 40 year old woman with depression, PTSD, and PCOS presents with continued abdominal pain. She localizes the pain to a highly discrete region of her lower right abdomen 2cm in diameter near the lateral aspect of the rectus abdominus sheath. The character of the pain is difficult to describe, and it's worse with standing, walking, stretching, laughing, coughing, and sneezing. While supine, you ask her to raise both legs off the table, and touching the area produces greater pain. Her past surgical history includes a cholecystectomy, appendectomy, and lysis of adhesions. She takes several hydrocodone-acetaminophen pills a day, an oral contraceptive, and sertraline. The rest of her review of systems is negative.
Challenge: What's your diagnosis?