Acute Appendicitis: A Case Report

Abstract

Acute appendicitis is an inflammation of the vermiform appendix, typically characterized by abdominal pain that migrates from the periumbilical region to the right lower quadrant. Variations in the anatomical position of the appendix may affect its clinical presentation and mimic other conditions, including urinary tract disorders. Case A 24-year-old male presented with right lower abdominal pain that had begun three days before hospital admission, accompanied by nausea, vomiting, decreased appetite, and fever. Physical examination revealed a temperature of 39.8°C, McBurney’s point tenderness, rebound tenderness, muscular guarding, and a positive psoas sign. Laboratory investigations showed leukocytosis of 13,390/µL, microscopic hematuria, and ketonuria. The patient was diagnosed with acute appendicitis and underwent appendectomy. Histopathological examination confirmed acute appendicitis. The diagnosis of acute appendicitis in this patient was supported by pain migration, signs of peritoneal irritation, fever, and leukocytosis. Pain radiating to the flank, a positive psoas sign, and urinary symptoms suggested a possible retrocecal position of the appendix and made right-sided urolithiasis an important differential diagnosis. Acute appendicitis may mimic urinary tract disorders because of variations in the anatomical position of the appendix. A thorough history, physical examination, and appropriate diagnostic investigations are essential for establishing the diagnosis and determining appropriate management.