Screening Ultrasonography in a Basic Emergency Service for Suspected Acute Appendicitis: A Case Report

Suspected acute appendicitis is a frequent clinical scenario in Basic Emergency Service (BES), particularly among patients presenting with acute abdominal pain. However, its clinical presentation is not always straightforward. In the early stages, symptoms may be nonspecific and overlap with other causes of abdominal pain, while the limited diagnostic resources available in peripheral emergency units may reduce the certainty of the initial clinical assessment. We present the case of a 22-year-old male who presented to a BES with acute abdominal pain associated with vomiting and food intolerance, with pain predominantly located in the lower abdominal quadrants and more evident on the right side. In the setting of a clinical presentation suggestive of acute appendicitis, screening ultrasonography was not intended to establish a definitive diagnosis but rather to add objective clinical information to the initial assessment and support a more reasoned decision regarding patient management. The identification of sonographic findings compatible with possible acute appendicitis strengthened the clinical suspicion and contributed to justifying central hospital referral. This case supports the potential role of screening ultrasonography as a complementary tool in peripheral or prehospital emergency settings, particularly when clinical findings are suggestive but insufficient to guide patient management with confidence. In such contexts, ultrasonography may help support decisions ranging from local treatment and discharge to hospital referral or follow-up by the patient's family physician.