Chronic appendicitis; the overlooked cause of chronic abdominal pain: Case report.

Abstract

Introduction: Acute appendicitis is a surgical emergency and the diagnosis is straightforward in majority of the cases. However, chronic appendicitis, a relatively rare cause of chronic abdominal pain, presents a unique challenge due to its atypical presentation. This rarity underscores the need for vigilance and thoroughness in our practice to avoid misdiagnosis or delay in diagnosis.

Case presentation: We present a case of chronic appendicitis in which a 30-year-old male patient presented with a nine-month history of chronic abdominal pain with mild right lower quadrant tenderness. Abdominal ultrasound suggested a feature of appendicitis, and the patient underwent appendectomy; finally, the diagnosis was confirmed on the histopathologic exam.

Discussion: Chronic appendicitis, a relatively rare condition, is often diagnosed late due to a lack of well-developed diagnostic criteria and atypical presentation. However, using abdominal U/S and CT scan imaging plays a crucial role in assessing chronic appendicitis, highlighting the importance of these tools in our practice. In many cases, the ultimate diagnosis is confirmed after a histopathology exam, reinforcing the need for a comprehensive approach to diagnosis.

Conclusion: Chronic appendicitis can have an atypical presentation with milder symptoms, and it should be considered in the differential diagnosis of patients presenting with chronic right lower quadrant abdominal pain. Abdominal U/S is an important imaging modality in assessing suspect cases of chronic appendicitis.