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Left sided appendicitis - a surgical dilemma: Case report.

Zohaib Mushtaq¹, Muhammad Zeeshan Sarwar¹, Yaseen Rafi¹

¹Department of East Surgical Ward, Mayo Hospital, King Edward Medical University, Lahore, Pakistan.

JPMA. the Journal of the Pakistan Medical Association

|June 6, 2021

Summary

Acute appendicitis rarely presents as left-sided abdominal pain, complicating diagnosis and treatment. This case highlights the importance of considering appendicitis even with atypical symptoms, especially when combined with midgut malrotation.

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Area of Science:

Gastroenterology
Surgical Case Reports

Background:

Acute appendicitis is a common surgical emergency, typically presenting with right lower quadrant abdominal pain.
Left-sided abdominal pain is an atypical presentation that can mimic other gastrointestinal or genitourinary conditions.

Observation:

A middle-aged male presented with left-sided abdominal pain, a rare initial symptom for acute appendicitis.
The patient was also found to have asymptomatic midgut malrotation, a congenital anomaly of intestinal rotation.

Findings:

The patient was diagnosed with acute appendicitis despite the atypical left-sided pain presentation.
The co-occurrence of acute appendicitis and asymptomatic midgut malrotation presented diagnostic challenges.

Implications:

Keywords:

Left-sided Abdominal Pain, Left-sided Appendicitis, Midgut Malrotation, Acute Abdomen.

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This case underscores the need for a high index of suspicion for appendicitis in patients with left-sided abdominal pain.
Recognizing unusual presentations and associated anomalies like midgut malrotation is crucial for timely diagnosis and improved patient outcomes.