Chronic appendicitis; the overlooked cause of chronic abdominal pain: Case report

Acute appendicitis is a surgical emergency and the diagnosis is straightforward in majority of the cases. However, chronic appendicitis, a relatively rare cause of chronic abdominal pain, presents a unique challenge due to its atypical presentation. This rarity underscores the need for vigilance and thoroughness in our practice to avoid misdiagnosis or delay in diagnosis.

We present a case of chronic appendicitis in which a 30-year-old male patient presented with a nine-month history of chronic abdominal pain with mild right lower quadrant tenderness. Abdominal ultrasound suggested a feature of appendicitis, and the patient underwent appendectomy; finally, the diagnosis was confirmed on the histopathologic exam.

Chronic appendicitis, a relatively rare condition, is often diagnosed late due to a lack of well-developed diagnostic criteria and atypical presentation. However, using abdominal U/S and CT scan imaging plays a crucial role in assessing chronic appendicitis, highlighting the importance of these tools in our practice. In many cases, the ultimate diagnosis is confirmed after a histopathology exam, reinforcing the need for a comprehensive approach to diagnosis.

Chronic appendicitis can have an atypical presentation with milder symptoms, and it should be considered in the differential diagnosis of patients presenting with chronic right lower quadrant abdominal pain. Abdominal U/S is an important imaging modality in assessing suspect cases of chronic appendicitis.