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Chronic appendicitis diagnosed preoperatively as an ovarian dermoid
Jo T Vanwinter1, Derek A Beyer
1Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA.
Journal of Pediatric and Adolescent Gynecology
|December 18, 2004
Summary
Chronic appendicitis can mimic other conditions like pelvic inflammatory disease in young women. This case highlights the importance of considering chronic appendicitis in recurrent lower abdominal pain, even when initial diagnoses and imaging suggest otherwise.
Area of Science:
- Gastroenterology
- Gynecology
Background:
- Recurrent right lower quadrant pain in young women presents a diagnostic challenge.
- Pelvic inflammatory disease (PID) and other gynecological conditions are common considerations.
Observation:
- A 19-year-old woman presented with recurrent right lower quadrant pain.
- Initial diagnosis of PID was made based on symptoms and lab results, but pain recurred after treatment.
- Computed tomography (CT) suggested an ovarian dermoid, but laparoscopy revealed normal adnexa.
Findings:
- Laparoscopy confirmed chronic appendicitis as the cause of recurrent pain.
- CT imaging, while often accurate for pelvic abnormalities, can be misleading.
Implications:
- Chronic appendicitis should be included in the differential diagnosis for recurrent lower abdominal pain in young women.
- Diagnostic imaging may not always accurately identify the source of pain, necessitating surgical exploration.
- This case underscores the potential for misdiagnosis and the importance of thorough evaluation.