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Left-sided acute appendicitis: a pitfall in the emergency department
Chih-Ying Yang1, Hsiao-Yen Liu, Hsing-Lin Lin
1Department of Emergency Medicine, E-Da Hospital/I-Shou University, Kaohsiung County, Taiwan.
The Journal of Emergency Medicine
|May 10, 2011
Summary
A rare case of left-sided appendicitis in a patient with a redundant and mobile colon highlights diagnostic challenges. This anatomical variation can mimic other conditions, delaying critical treatment for acute appendicitis.
Area of Science:
- Gastroenterology
- Surgical Anatomy
- Emergency Medicine
Background:
- Acute appendicitis is a common surgical emergency with typical right lower quadrant pain.
- Atypical presentations, such as left-sided appendicitis, are rare and often associated with congenital anomalies.
- Delayed diagnosis of appendicitis can lead to severe complications.
Observation:
- A 50-year-old male presented with left lower abdominal pain and fever.
- Imaging revealed a redundant, mobile ascending colon and an inflamed appendix in the left abdomen.
- Surgical exploration confirmed perforated appendicitis with associated fluid.
Findings:
- The patient had a redundant and hypermobile ascending colon, an unusual anatomical finding.
- The inflamed appendix was located in the left lower quadrant, causing atypical symptoms.
- Perforation and ascites were noted during exploratory laparotomy.
Implications:
- This case underscores the importance of considering anatomical variations in diagnosing appendicitis.
- Emergency physicians should be aware of left-sided appendicitis presentations, especially with mobile colonic structures.
- Prompt diagnosis and surgical intervention are crucial for favorable outcomes in atypical appendicitis cases.
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