Acute Appendicitis Presenting As Left Flank Pain: A Case Report

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2024 Jul 12

PMID 38993448

Authors

Ibrahim Badawy

Khaled Mbaya

Hesham Metwally

Affiliations

Soon will be listed here.

Abstract

Acute appendicitis (AA) is a common surgical emergency. The diagnosis is mainly clinical and is largely based on the typical presentation of periumbilical pain radiating to the right iliac fossa. However, atypical presentations have been reported in the literature. Left-sided appendicitis is a rare presentation. Imaging with ultrasonography (US) and computed tomography (CT) is of paramount importance in such cases to aid diagnosis and exclude other causes. We report a case of a 21-year-old man who presented with acute left flank pain. He was diagnosed with AA by CT, which showed an appendix diameter of 13 mm.

References

Tawk C, Zgheib R, Mehanna S . Unusual case of acute appendicitis with left upper quadrant abdominal pain. Int J Surg Case Rep. 2012; 3(8):399-401. PMC: 3376725. DOI: 10.1016/j.ijscr.2012.05.002. View

Aassouani F, Charifi Y, Hajjar C, El Bouardi N, Haloua M, Alami B . Left-sided appendicitis revealing a common mesentery: A Case Report. Radiol Case Rep. 2022; 17(10):3718-3721. PMC: 9357839. DOI: 10.1016/j.radcr.2022.07.009. View

Yang C, Liu H, Lin H, Lin J . Left-sided acute appendicitis: a pitfall in the emergency department. J Emerg Med. 2011; 43(6):980-2. DOI: 10.1016/j.jemermed.2010.11.056. View

Akbulut S, Caliskan A, Ekin A, Yagmur Y . Left-sided acute appendicitis with situs inversus totalis: review of 63 published cases and report of two cases. J Gastrointest Surg. 2010; 14(9):1422-8. DOI: 10.1007/s11605-010-1210-2. View

Fenwick A, Hartery A . Appendicitis and beyond: a pictorial review of various appendiceal abnormalities. Emerg Radiol. 2021; 28(3):651-664. DOI: 10.1007/s10140-021-01908-3. View

Alvarado A . How to improve the clinical diagnosis of acute appendicitis in resource limited settings. World J Emerg Surg. 2016; 11:16. PMC: 4845369. DOI: 10.1186/s13017-016-0071-8. View

Zacharzewska-Gondek A, Szczurowska A, Guzinski M, Sasiadek M, Bladowska J . A pictorial essay of the most atypical variants of the vermiform appendix position in computed tomography with their possible clinical implications. Pol J Radiol. 2019; 84:e1-e8. PMC: 6479055. DOI: 10.5114/pjr.2018.81158. View

Teng T, Thong X, Lau K, Balasubramaniam S, Shelat V . Acute appendicitis-advances and controversies. World J Gastrointest Surg. 2021; 13(11):1293-1314. PMC: 8649565. DOI: 10.4240/wjgs.v13.i11.1293. View

Koroglu M, Wendel J, Ernst R, Oto A . Alternative diagnoses to stone disease on unenhanced CT to investigate acute flank pain. Emerg Radiol. 2004; 10(6):327-33. DOI: 10.1007/s10140-004-0336-5. View

10.

Talanow R . An unusual manifestation of acute appendicitis with left flank pain. J Radiol Case Rep. 2012; 2(1):8-11. PMC: 3303231. DOI: 10.3941/jrcr.v2i1.27. View

11.

DSouza N, Hicks G, Beable R, Higginson A, Rud B . Magnetic resonance imaging (MRI) for diagnosis of acute appendicitis. Cochrane Database Syst Rev. 2021; 12:CD012028. PMC: 8670723. DOI: 10.1002/14651858.CD012028.pub2. View