title: Clinical confounder: an incarcerated appendix masquerading as epididymitis.
abstract: BACKGROUND
  Acute appendicitis can have various unusual presentations. Detection of this entity is often confounded by its presence in the company of symptoms consistent with distinctly different etiologies.
  
  
  OBJECTIVE
  This article highlights an extremely rare presentation of appendicitis.
  
  
  METHODS
  The case of a man presenting to an urban Emergency Department complaining of scrotal swelling and pain is discussed. On surgical exploration, the patient's symptomatology was diagnosed as acute appendicitis within an Amyand hernia.
  
  
  CONCLUSIONS
  Appendicitis can sometimes be a challenging diagnosis. Thorough examination and maintenance of a wide differential diagnosis with common complaints can assist the emergency physician in reaching the correct diagnosis.
authors.affiliation: Department of Emergency Medicine, Virginia Commonwealth University Medical Center, Richmond, Virginia, USA.
authors.forename: Keel
authors.initials: K
authors.lastname: Coleman
authors.forename: Taruna
authors.initials: T
authors.lastname: Aurora
authors.forename: Pawan
authors.initials: P
authors.lastname: Suri
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Hoffman
mesh_terms: D000208:Acute Disease; D001064:Appendicitis / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004823:Epididymitis / Q000175:diagnosis*; D006552:Hernia, Inguinal / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged