Another mistaken case of appendicitis.
In 2010, when I was 17, I presented to hospital with progressive discomfort and pain in the right iliac fossa when eating and moving, associated with mild fever and diarrhoea. Appendicitis was suspected but immediate surgery was deferred, as the inflammatory markers did not adequately support the clinical diagnosis of appendicitis. Further tests, including MRI, were then undertaken. The MRI showed evidence of terminal ileitis and a normal appendix. Crohn's disease was considered as part of the differential diagnosis. However, a Yersinia enterocolitica infection was subsequently confirmed. The episode highlighted several learning points including preventing unnecessary surgery and the advantages of using a multidisciplinary approach involving imaging the abdomen and microbiological input.
GKT School of Medical Education, King's College London, London, UK.
Nidhin
N
Laji
Department of General Surgery, Western Sussex Hospitals NHS Foundation Trust, Chichester, West Sussex, UK.
Richard
R
Bowyer
Department of Medical Microbiology, King's College Hospital NHS Foundation Trust, London, UK.
Dakshika
D
Jeyaratnam
South London Specialist Virology Centre, King's College Hospital NHS Foundation Trust, London, UK.
Mark
M
Zuckerman
D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D001064:Appendicitis / Q000175:diagnosis*; D003424:Crohn Disease / Q000175:diagnosis; D003937:Diagnosis, Differential; D006801:Humans; D007079:Ileitis / Q000175:diagnosis*; D010348:Patient Care Team; D019564:Unnecessary Procedures; D015009:Yersinia Infections / Q000175:diagnosis*