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Case Reports
. 2014 Nov;15(7):852-4.
doi: 10.5811/westjem.2014.7.23037. Epub 2014 Sep 19.

A gut feeling: an extremely rare case of missed appendicitis

Ashley Pilgrim  1 , Rachel Russo  2 , Aimee Moulin  1
Affiliations
Case Reports

A gut feeling: an extremely rare case of missed appendicitis

Ashley Pilgrim et al. West J Emerg Med. 2014 Nov.

Abstract

This case outlines the emergency department and surgical course of a 63-year-old male presenting with acute onset abdominal pain. Appendicitis was high on the differential for the treating physician, but after the computed tomography and laboratory evaluation were unremarkable, the patient was discharged only to return the next day. What ensued was one of the rarest cases of missed appendicitis documented in the medical literature.

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Figures

Figure 1
Figure 1
A & B, Arrows illustrating sagital and axial views of appendix entering umbilical hernia sac.
Figure 2
Figure 2
Limited midline laparotomy revealing umbilical hernia sac containing the perforated tip of the appendix. A, Perforation at the tip of the appendix with inflamed mesoappendix within the hernia sac. B, Body of appendix. C, Base of the appendix, joining the cecum.
See this image and copyright information in PMC

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