Acute ruptured appendicitis and peritonitis with pseudomyocardial infarction.
Acute abdominal conditions unexpectedly present with electrocardiographic changes. However, the presence of electrocardiographic changes and misleading clinical manifestations may obscure true etiology and delay surgical interventions. We present a patient who developed ruptured appendicitis with peritonitis manifested as acute inferior wall myocardial infarction-like electrocardiographic changes. A thorough physical examination and early echocardiographic evaluation helped to differentiate this pseudomyocardial infarction. A 64-multidetector-row computed tomography of the abdomen showed ruptured retrocecal appendicitis, and emergent appendectomy was done. Normalization of ST segments was observed after surgery.
Liao
Wen-I
WI
Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan.
Tsai
Shih-Hung
SH
Chu
Shi-Jye
SJ
Hsu
Ching-Wang
CW
Lin
Yen-Yue
YY
D001064:Appendicitis / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000382:microbiology; D015415:Biomarkers / Q000032:analysis; D003937:Diagnosis, Differential; D004562:Electrocardiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis; D010538:Peritonitis / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000382:microbiology; D014057:Tomography, X-Ray Computed / Q000379:methods
D015415:Biomarkers