title: Complicated acute appendicitis? An unusual differential.
abstract: Acute appendicitis is a common surgical diagnosis but several differential diagnoses exist and should be considered. Internal concealment is one such diagnosis. We present a case of a young man taken to the operating room with a preoperative diagnosis of complicated acute appendicitis. A ruptured caecum was encountered and several free-floating drug pellets were present. Attending doctors should consider this differential in the high prevalence areas and, whenever encountered, they should strongly consider early reporting.
authors.affiliation: Hepatobiliary Surgeon, Department of Clinical Surgical Sciences, University of the West Indies, St Augustine Campus, Trinidad & Tobago socawich@hotmail.com.
authors.forename: Shamir O
authors.initials: SO
authors.lastname: Cawich
authors.affiliation: Consultant Surgeon, Department of Clinical Surgical Sciences, University of the West Indies, St Augustine Campus, Trinidad & Tobago.
authors.forename: Dale
authors.initials: D
authors.lastname: Hassranah
authors.affiliation: Consultant Surgeon, Department of Clinical Surgical Sciences, University of the West Indies, St Augustine Campus, Trinidad & Tobago.
authors.forename: Suresh
authors.initials: S
authors.lastname: Pooran
authors.affiliation: Consultant Surgeon, Department of Clinical Surgical Sciences, University of the West Indies, St Augustine Campus, Trinidad & Tobago.
authors.forename: Dilip
authors.initials: D
authors.lastname: Dan
authors.affiliation: Professor of Surgery, Department of Clinical Surgical Sciences, University of the West Indies, St Augustine Campus, Trinidad & Tobago.
authors.forename: Vijay
authors.initials: V
authors.lastname: Narayansingh
mesh_terms: D000208:Acute Disease; D000328:Adult; D001064:Appendicitis / Q000175:diagnosis; D002429:Cecal Diseases / Q000139:chemically induced / Q000150:complications / Q000175:diagnosis*; D003937:Diagnosis, Differential; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects; D007416:Intestinal Perforation / Q000139:chemically induced / Q000175:diagnosis* / Q000601:surgery; D008297:Male
chemical_list: D013287:Illicit Drugs
keywords: Appendicitis; complicated; drug; packer; surgery