Chronic appendicitis misdiagnosed as a periappendiceal orifice polyp: a case report.

J Med Case Rep

Internal Medicine Department, College of Medicine, Prince Sattam Bin Abdulaziz University, P.O. Box 173, 11942, Al-Kharj, Saudi Arabia.

Published: October 2024

AI Article Synopsis

  • Chronic appendicitis presents with vague abdominal pain and can often be misdiagnosed, potentially leading to serious complications if not identified correctly.
  • A 55-year-old male experienced recurring mild right lower abdominal pain for two years, along with nausea and bloating, but no severe symptoms; tests eventually revealed chronic appendicitis with multiple appendicoliths.
  • The case emphasizes the value of using advanced imaging, like CT scans, to accurately diagnose chronic appendicitis, especially when symptoms don’t align with typical cases.

Article Abstract

Background: Unlike acute appendicitis, chronic appendicitis is characterized by nonspecific abdominal pain and intermittent course. This may lead to late diagnosis or misdiagnosis, with the possibility of serious complications.

Case Report: A male patient of Arab origin aged 55 years had a 2-year history of recurrent episodes of mild pain in the right lower quadrant of the abdomen. The episodes were associated with nausea, chills, and abdominal bloating but no vomiting, rectal bleeding, or weight loss. On examination, the patient showed soft and lax abdomen with mild tenderness in the right lower quadrant, with no organomegaly or abdominal masses. Laboratory findings showed normal complete blood count and C-reactive protein. The patient underwent colonoscopy to rule out malignancy, which showed appendiceal orifice polyp that required resection. The computed tomography scan showed an enlarged appendix with multiple intraluminal dense appendicoliths. The largest stone at the appendiceal orifice measured 1.5 cm × 0.9 cm and was partially protruding within the cecal lumen. The diagnosis of chronic appendicitis was confirmed. The patient underwent appendectomy and was asymptomatic a few days after discharge.

Conclusions: We are reporting a patient with chronic appendicitis presented with multiple appendicoliths. The patient was initially misdiagnosed as periappendiceal orifice polyp. The current finding highlights the importance of imaging, especially computed tomography in confirming the diagnosis in patients with atypical appendicitis presentation.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514870PMC
http://dx.doi.org/10.1186/s13256-024-04847-yDOI Listing

Publication Analysis

Top Keywords

chronic appendicitis
16
orifice polyp
12
misdiagnosed periappendiceal
8
periappendiceal orifice
8
lower quadrant
8
patient underwent
8
appendiceal orifice
8
computed tomography
8
patient
6
appendicitis
5

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!