Rare presentations of acute appendicitis


  • Pon Rachel Vedamanickam Department of Surgery, Baptist Christian Hospital, Assam, India




Acute appendicitis, Rare presentations, Epididymo-orchitis


Acute appendicitis is the one of the most common emergency conditions that the rural surgeon must deal with. Though the majority of patients present with the typical symptoms of right iliac fossa pain, nausea and anorexia, many patients do present with atypical symptoms and signs. These patients present a challenge to rural surgeons. Acute appendicitis is a great mimic and can present with a variety of symptoms. The eyes don’t see what the mind doesn’t know and it is important to know the various ways in which appendicitis can present and to always keep it as a differential diagnosis while managing a patient with acute abdomen. In this paper we have looked at 4 different presentations of appendicitis. Appendicitis is a great mimic and should always be kept as a differential for acute abdomen.


McConkey SJ. Case Series of Acute Abdominal Surgery in Rural Sierra Leone. World J Surg. 2002;26:509-13.

Humes DJ, Simpson J. Acute appendicitis. BMJ. 2006;333:530-4.

Nshuti R, Kruger D, Luvhengo TE. Clinical presentation of acute appendicitis in adults at the Chris Hani Baragwanath academic hospital. Int J Emerg Med. 2014;7:12.

Terasawa T, Blackmore CC, Bent S, Kohlwes RJ. Systematic review: computed tomography and ultrasonography to detect acute appendicitis in adults and adolescents. Ann Intern Med. 2004;141:537-46.

Najafizadeh-sari S, Mehdizadeh H, Bagheri-baghdasht MS, Manoochehry S. Suppurative appendicitis presenting acute scrotal pain: a rare condition may confuse surgeons. J Surg Case Rep. 2017.

Shumon S, Bennett J, Lawson G, Small P. Suppurative appendicitis presenting as acute scrotum confounded by a testicular appendage. J Surg Case Rep. 2016;2016(3):rjw027.

Mahmood RD. Appendiceal diverticulosis. BMJ Case Reports. 2010;2010:bcr0720092090.

Sohn T.J. Clinical characteristics of acute appendiceal diverticulitis. J Korean Surg Soc. 2013;84:33-7.

Yamana I. Clinical characteristics of 12 cases of appendiceal diverticulitis: a comparison with 378 cases of acute appendicitis. Surg. Today. 2012;42:363-7.

Mangi AA, Berger DL. Stump appendicitis. The American Surgeon; Atlanta. 2000;66:739-41.

Roberts KE, Starker LF, Duffy AJ, Bell RL, Bokhari J. Stump appendicitis: a surgeon's dilemma. JSLS. 2011;15(3):373-8.

Jones BA, Demetriades D, Segal I, Burkitt DP. The prevalence of appendiceal fecaliths in patients with and without appendicitis. A comparative study from Canada and South Africa. Jones Ann Surg. 1985;202(1):80-2.






Case Reports