<abstract xmlns="http://www.w3.org/1999/xhtml"><p>The appendix is a worm-like, blind-ending tube, with its base on the caecum and its tip in multiple locations. Against all odds, it plays a key role in the digestive immune system and appendectomy should therefore be cautiously considered and indicated. We report the case of a 45-year-old male with a known history of Fragile-X syndrome who presented to the emergency department with intense abdominal pain and was suspected of acute appendicitis, after a positive Dieulafoy’s triad was confirmed. The laparoscopic exploration showed no signs of inflammation of the appendix; nonetheless, its removal was carried out. Rising inflammatory laboratory parameters led to a focused identification of a pleural empyema due to a tooth inlay aspiration. Our objective is to emphasize the importance of a thorough anamnesis, even in cases of mentally impaired patients, as well as to highlight a rare differential diagnosis for appendicitis. Acute appendicitis is an emergency condition that requires a thorough assessment and appropriate therapy. Clinical examinations are important, but in this particular case, imaging methods had a much more important role in establishing the right treatment approach. Furthermore, the signs of acute appendicitis are mimicked by several medical conditions including respiratory tract infections.</p></abstract>

The appendix is a worm-like, blind-ending tube, with its base on the caecum and its tip in multiple locations. Against all odds, it plays a key role in the digestive immune system and appendectomy should therefore be cautiously considered and indicated. We report the case of a 45-year-old male with a known history of Fragile-X syndrome who presented to the emergency department with intense abdominal pain and was suspected of acute appendicitis, after a positive Dieulafoy’s triad was confirmed. The laparoscopic exploration showed no signs of inflammation of the appendix; nonetheless, its removal was carried out. Rising inflammatory laboratory parameters led to a focused identification of a pleural empyema due to a tooth inlay aspiration. Our objective is to emphasize the importance of a thorough anamnesis, even in cases of mentally impaired patients, as well as to highlight a rare differential diagnosis for appendicitis. Acute appendicitis is an emergency condition that requires a thorough assessment and appropriate therapy. Clinical examinations are important, but in this particular case, imaging methods had a much more important role in establishing the right treatment approach. Furthermore, the signs of acute appendicitis are mimicked by several medical conditions including respiratory tract infections.

Uncommon Differential Diagnosis of Acute Right-sided Abdominal Pain – Case Report

Department of Surgery, Emergency County Hospital

University of Medicine, Pharmacy, Science and Technology

Department of General, Abdominal and Endovascular Surgery

Journal of Interdisciplinary Medicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

The appendix is a worm-like, blind-ending tube, with its base on the caecum and its tip in multiple locations. Against all odds, it plays a key role in the...

Uncommon Differential Diagnosis of Acute Right-sided Abdominal Pain – Case Report

Published Online: Jul 18, 2019

Page range: 33 - 36

Received: Feb 22, 2019

Accepted: Mar 27, 2019

DOI: https://doi.org/10.2478/jim-2019-0004

Keywords
appendicitis, pleural empyema, differential diagnosis, tooth inlay aspiration

© 2019 Cédric Kwizera et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Uncommon Differential Diagnosis of Acute Right-sided Abdominal Pain – Case Report

Published Online: Jul 18, 2019

Page range: 33 - 36

Received: Feb 22, 2019

Accepted: Mar 27, 2019

DOI: https://doi.org/10.2478/jim-2019-0004

Keywordsappendicitis, pleural empyema, differential diagnosis, tooth inlay aspiration

© 2019 Cédric Kwizera et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
appendicitis, pleural empyema, differential diagnosis, tooth inlay aspiration