Chronic Appendicitis: An Often Forgotten Cause of Recurrent Abdominal Pain

Published:November 21, 2012DOI:
      A 28-year-old woman presented with a 3-day history of worsening abdominal pain localized to the right lower quadrant. Her symptoms began with a sharp discomfort originating along the right abdomen with associated radiation to the lower back. She recalled no inciting event and denied fevers, nausea, vomiting, diarrhea, hematuria, dysuria, or vaginal discharge. She reported compliance with a hormonal contraception vaginal ring prescribed for “menstrual pain.” On further questioning, the patient had experienced 6 similar episodes of right-sided abdominal pain over the past 2 years, each resolving spontaneously after 3-4 days with conservative measures. She was evaluated on several occasions for this pain with no clear diagnosis. At one point she was treated with antibiotics for a presumed urinary tract infection. She had never undergone computed tomography (CT) imaging.
      To read this article in full you will need to make a payment


      Subscribe to The American Journal of Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • VanWinter J.T.
        • Beyer D.A.
        Chronic appendicitis diagnosed preoperatively as an ovarian dermoid.
        J Pediatr Adolesc Gynecol. 2004; 17: 403-406
        • Hawes A.S.
        • Whalen G.H.
        Recurrent and chronic appendicitis: the other inflammatory conditions of the appendix.
        Am Surg. 1994; 60: 217
        • Rao P.M.
        • Rhea J.T.
        • Noveline R.A.
        • et al.
        Helical CT technique for the diagnosis of appendicitis: prospective evaluation of a focused CT examination.
        Radiology. 1997; 202: 139-144
        • Mueller B.A.
        • Daling J.R.
        • Moore D.E.
        • et al.
        Appendectomy and the risk of tubal infertility.
        N Engl J Med. 1986; 315: 1506