DIFFERENTIAL DIAGNOSIS OF APPENDICITIS

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The signs and symptoms of appendicitis are often mimicked by over a dozen other illnesses. A list of the differential diagnosis of appendicitis is made up of all these other causes of right side lower abdominal pain and other symptoms of appendicitis.

It is crucial and extremely important that these differential diagnosis or mimickers of appendicitis be considered any time anyone presents with signs and symptoms thought to be due to appendicitis. A more swiftly fatal but easily remediable medical condition can be missed with ugly results if a consideration is not given to the differential diagnosis of appendicitis.

A quick example in this regard is ectopic pregnancy in a woman. This is a commonly missed differential diagnosis of appendicitis.

Ectopic pregnancy occurs when a newly formed pregnancy settles anywhere outside the uterus, instead of inside the uterus. This commonly occurs within the fallopian tubes. As the foetus grows, the lumen of the tube becomes far too narrow for it, and the tube may rupture, leading to loss of the baby and massive bleeding from the large blood vessels in the tube. Within hours, a woman could loose all her blood into the abdominal cavity. Sometimes, the bleeding may be minimal if it is just a crack on the wall of the tube … a leak instead of torrential blood loss.

Such women will come up with sudden onset right sided lower abdominal pain, may vomit, and even have mildly raised temperature, and other signs and symptoms of appendicitis. She may not be aware she is pregnant, since leaking or ruptured ectopic pregnancy usually happened within the first 6 – 8 weeks of pregnancy (just when she notices she has missed her period or menses).

If an unwary doctor fails to consider this as one of the differential diagnosis of appendicitis, she may bleed to death before being taken to theatre!The list of the differential diagnosis of appendicitis presented here is not exhaustive, and includes:

In Children

• Mesenteric Lymphadenitis.
  
  
• Abdominal Migraine
  
  
• Non Specific Abdominal Pain

In Females

• Mid-Cycle pain
  
  
• Pelvic Inflammatory Disease
  
  
• Right sided Ovarian Cyst
  
  
• Endometriosis
  
  
• Right sided Ectopic pregnancy

In Anyone

• Constipation
  
  
• Crohns Disease
  
  
• Diverticulitis
  
  
• Peptic Ulcer
  
  
• Caecal tumour
  
  
• Gallbladder Disease
  
  
• Cholecystitis
  
  
• Gastroenteritis
  
  
• Rectus Sheath Haematoma
  
  
• Pancreatitis
  
  
• Urinary Tract Infection
  
  
• Kidney stone

Click on the above links to see the each of these illnesses that makes up a differential diagnosis of appendicitis.

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