A 56-year-old woman presented to the emergency department with a 1-month history of abdominal pain in the left upper quadrant. Her medical history was notable for polysubstance use disorder, hepatitis C virus infection, and rheumatoid arthritis managed with naproxen. Computed tomography of the abdomen was performed. What is the most likely diagnosis?

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A. Avascular necrosis of the spleen

B. Visceral leishmaniasis

C. Emphysematous infection of the spleen

D. Gastrosplenic fistulization

E. Bezoar

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