Perforated appendicitis masquerading as acute pancreatitis in a morbidly obese patient.
Diagnosis and treatment of common conditions in morbidly obese patients still pose a challenge to physicians and surgeons. Sometimes too much reliance is put on investigations that can lead to a misdiagnosis. This case demonstrates an obese woman admitted under the medical team with a presumed diagnosis of pneumonia, who was later found to have an acute abdomen and raised amylase, which led to an assumed diagnosis of pancreatitis. She died within 24 h of admission and post mortem confirmed the cause of death as systemic sepsis due to perforated appendicitis, with no evidence of pancreatitis. Significantly elevated serum amylase level may occur in non-pancreatitic acute abdomen.
Forster
Michael-J
MJ
Department of Surgery, Plymouth Hospitals NHS Trust Plymouth, PL6 8DH, United Kingdom.
Akoh
Jacob-A
JA
D000006:Abdomen, Acute / Q000201:enzymology / Q000209:etiology*; D000208:Acute Disease; D000681:Amylases / Q000097:blood; D001064:Appendicitis / Q000150:complications / Q000175:diagnosis* / Q000201:enzymology; D003937:Diagnosis, Differential; D003951:Diagnostic Errors / Q000517:prevention & control*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications* / Q000201:enzymology; D010195:Pancreatitis / Q000150:complications / Q000175:diagnosis*; D010538:Peritonitis / Q000209:etiology; D018805:Sepsis / Q000209:etiology; D015854:Up-Regulation
D000681:Amylases