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Acute abdomen caused by both acute appendicitis and epididymitis
Hajime Nakatani1, Shinichi Hamada, Toyotake Okanoue
1Department of Surgery, Kubokawa Hospital, Kochi, Japan.
The Journal of Medical Investigation : JMI
|September 17, 2011
Summary
Acute appendicitis, a common cause of abdominal pain, rarely involves scrotal symptoms. This case report details the first instance of acute appendicitis occurring simultaneously with acute epididymitis in a 63-year-old man.
Area of Science:
- Gastroenterology
- Urology
- Surgical Case Reports
Background:
- Acute appendicitis is a common surgical emergency, typically presenting with right lower quadrant pain.
- Scrotal involvement in appendicitis is exceptionally rare, making diagnosis challenging.
- Early recognition of atypical presentations is crucial for timely intervention.
Observation:
- A 63-year-old male presented with severe right lower quadrant pain, fever, and classic appendicitis signs (McBurney's and Lanz points tenderness, Blumberg's sign).
- Additionally, he exhibited scrotal swelling, local heat, and severe testicular pain.
- Computed tomography revealed pelvic ascites and a swollen right spermatic cord.
Findings:
- The patient was diagnosed with catarrhal appendicitis and acute epididymitis.
- This represents the first reported case of concomitant acute appendicitis and acute epididymitis.
- The swollen spermatic cord on CT correlated with the scrotal findings.
Implications:
- This case highlights the importance of considering genitourinary pathology in patients with suspected appendicitis, especially with atypical scrotal symptoms.
- Clinicians should maintain a broad differential diagnosis for abdominal and scrotal pain.
- Further investigation into the mechanisms linking appendicitis and epididymitis may improve diagnostic accuracy and patient outcomes.
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