Twisting lipoma presenting as appendicitis-a rare presentation

Area of Science:

• General Surgery
• Diagnostic Imaging
• Abdominal Pain Etiologies

Background:

• Right iliac fossa (RIF) pain is a frequent surgical presentation, commonly associated with acute appendicitis.
• Differential diagnoses for RIF pain are extensive, necessitating thorough investigation.

Observation:

• A young female presented with a month of intermittent right lower abdominal pain, clinically suggestive of acute appendicitis.
• Initial ultrasonography revealed no significant abnormalities, posing a diagnostic challenge.

Findings:

• Diagnostic laparoscopy identified a rare cause of RIF pain: torsion of a pedunculated lipoma of the anterior abdominal wall parietal peritoneum.
• This condition mimicked the clinical presentation of acute appendicitis.

Implications:

• This case underscores the importance of considering rare differential diagnoses for RIF pain, even when clinical signs point towards common conditions like appendicitis.
• Laparoscopy proved crucial in diagnosing this unusual etiology, guiding appropriate management.