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Aberrant Diagnostic Imaging Resulting in Misdiagnosed Acute Perforated Appendicitis: A Case Report

Christian Przeslawski1, Leanne Iorio1, Jeffrey Gerken1

  • 1General Surgery, Corewell Health Southeast - Farmington Hills Campus, Farmington Hills, USA.

Cureus
|March 18, 2024
PubMed

Insights

A perforated appendix was initially misdiagnosed as diverticulitis based on CT scans. This case underscores the importance of clinical evaluation over imaging alone for accurate diagnosis and treatment of acute abdominal pain.

Area of Science:

  • Gastroenterology
  • Surgical Case Reports

Background:

  • Diverticulitis and appendicitis are common causes of acute abdominal pain.
  • Computed tomography (CT) is frequently used for initial diagnosis of abdominal pathologies.

Observation:

  • A 31-year-old male with suspected perforated diverticulitis presented with right-sided abdominal pain.
  • Initial CT revealed free air and inflammatory changes suggestive of diverticulitis.

Findings:

  • Diagnostic laparoscopy revealed acute perforated appendicitis, not diverticulitis.
  • The appendix showed mild adherence to the sigmoid colon.

Implications:

  • Highlights the critical role of thorough patient history and physical examination in surgical diagnosis.
  • Supports the use of laparoscopy for select cases of pneumoperitoneum, potentially reducing patient morbidity compared to open laparotomy.
Keywords:
appendicitis misdiagnosed as diverticulitisct evaluation acute appendicitisdiagnostic laparoscopy in acute abdomendiagnostic laparoscopy in perforated viscusintraabdominal appendix locations

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