Presentation
History of right sided abdominal pain since morning, vomited 7 times with anorexia and there is burning micturition, no fever, no loose motion Physical Exam: abdomen soft, lax, right iliac fossa severe tenderness with rebound pain.
Patient Data
RIF shows hypoechoic, blind non compressible painful structure measuring 13mm surrounded by hypervascularity fat stranding and thick contents, in keeping with acute appendicitis.
Blood CBC analysis shows high white blood cell and high neutrophils
Case Discussion
Sometimes, we can find acute appendicitis with normal blood CBC analysis.
The clinical examination and USG are very useful for diagnosis.
Differential diagnosis of a right iliac fossa pain includes,
- Appendicitis
- Crohn's disease
- Mesenteric adenitis
- Diverticulitis
- Meckel's diverticulitis
- Perforated peptic ulcer
- Right inguinal hernia/femoral hernia