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Updated: Jan 30, 2026

Author Spotlight: Quantifying Pain Experience – An Illustrative Approach Using the Pain Body Diagram
Published on: July 7, 2023
Pitfalls of Diagnosing Left Lower Quadrant Pain Causes: Making the Uncommon Common Again
Christian Saliba1, Samer H Diab1, Gregory Nicolas1
1Department of Surgery, Beirut General Hospital, Beirut, Lebanon.
Abstract:
BACKGROUND Left-sided acute appendicitis, although well described in the literature, is still an easily missed diagnosis. Midgut malrotation and situs inversus are 2 known leading conditions that contribute to misdiagnosis of appendicitis. CASE REPORT Here is the case of a 27-year-old male without any previous medical history, who presented with left lower quadrant tenderness and was misdiagnosed with gastroenteritis as an outpatient and sent home; the patient presented the next day to the emergency department where he was found to have acute appendicitis with situs inversus. He underwent laparoscopic appendectomy where a phlegmon was identified. Pathology came back as peri-appendiceal mucocele with no signs of malignancy. CONCLUSIONS This case report aimed to revisit the idea of left-sided acute appendicitis and discuss the management of a perforated appendiceal mucocele contained by a phlegmon.
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