title: Acute appendicitis presenting as acute gastritis in an adult patient with undiagnosed congenital gut malrotation: a case report.
abstract: BACKGROUND
  We report a case of an atypical presentation of acute appendicitis in an adult due to an undiagnosed congenital gut malrotation.
  
  
  OBJECTIVE
  The obvious benefit of observation with serial examinations followed by the use of computed tomography (CT) is discussed in aiding in the diagnosis for atypical presentations of appendicitis.
  
  
  METHODS
  A 45-year-old man who presented with epigastric pain and vomiting was diagnosed with acute left-sided appendicitis on CT scan. The patient's appendix was located in the left lower quadrant of the abdomen due to undiagnosed congenital gut malrotation, thus resulting in an atypical presentation of a common illness.
  
  
  CONCLUSIONS
  Observation with serial examinations, followed by CT scanning if indicated, is an invaluable strategy to use in diagnosing atypical presentations of common pathology.
authors.affiliation: Department of Emergency Medicine, Orlando Regional Medical Center, Orlando, FL 32806, USA.
authors.forename: Andrew David
authors.initials: AD
authors.lastname: Jones
authors.forename: David D
authors.initials: DD
authors.lastname: Cassidy
mesh_terms: D001062:Appendectomy; D001064:Appendicitis / Q000175:diagnosis* / Q000601:surgery; D003937:Diagnosis, Differential; D004636:Emergency Service, Hospital; D005756:Gastritis / Q000175:diagnosis; D006801:Humans; D007410:Intestinal Diseases / Q000151:congenital / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D014102:Torsion Abnormality / Q000151:congenital / Q000175:diagnosis*