xCh. 2 – A 33 year old man with abdominal pain

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2 thoughts on “xCh. 2 – A 33 year old man with abdominal pain

  1. This case reminds me of my own atypical presentation of appendicitis. Following the sudden onset of colicky peri-umbilical abdominal pain, I thought I too had a kidney stone. My with and without contrast CT was negative but did show a normal appearing retrocecal appendix. Luckily I was admitted for pain control as 6 hours later I spiked fevers, had a WBC of 27, and was hypotensive.

    I still remember being wheeled to the OR and the attending general surgeon saying he didn’t think it was my appendix but rather be a perforated ulcer. I was spared the huge laparotomy incision as it was a perf’ed appy. Cases like the one in this chapter and my own experience shows the diverse presentation of appendicitis, both clinical and radiographically.

  2. This case is an excellent example of how variations in anatomy can lead to atypical presentations thereby masking a correct diagnosis. In this case, the patient had a retrocecal appendix which can result in a far less impressive abdominal exam than expected with appendicitis as the cecum can effectively block the pressure of palpation.

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