Abstract
Normal appendix is 4 to 5 mm in diameter and approximately 8 cm in length; although it may be up to 30 cm long. Appendicitis is the inflammation of the appendix and is the most common cause of acute abdominal pain. Right lower quadrant pain, nausea, vomiting and fever are common signs of appendicitis but 20% to 33% of patients with suspected appendicitis present with atypical features. Case presentation: we presented a 14-year-old boy with abdominal pain predominantly in hypogastric area and LLQ (Left Lower Quadrant) that after ultrasound and CT study a large appendix 22 mm in diameter and 17 cm in length was detected. Conclusion: appendix position and size is very variable and appendicitis could be presented by different clinical features. In this case, the patient was presented with LLQ pain rather than RLQ (Right Lower Quadrant) pain due to its large size and elongation to the left side.
Highlights
IntroductionAppendix arises from posteromedial aspect of the caecum, 1 to 2 cm below the ileocecal valve
Nausea, vomiting and fever are common signs of appendicitis but 20% to 33% of patients with suspected appendicitis present with atypical features
Case presentation: we presented a 14-year-old boy with abdominal pain predominantly in hypogastric area and LLQ (Left Lower Quadrant) that after ultrasound and CT study a large appendix 22 mm in diameter and 17 cm in length was detected
Summary
Appendix arises from posteromedial aspect of the caecum, 1 to 2 cm below the ileocecal valve. Normal appendix is 4 to 5 mm in diameter and approximately 8 cm in length; it may be up to 30 cm long. Appendicitis is the inflammation of the appendix and is caused by a blockage of the hollow portion of the appendix, most commonly by a calcified particle called appendicolith, and is the most common cause of acute abdominal pain [1]. Nausea, vomiting, and a systemic inflammatory response. 20% to 33% of patients with suspected appendicitis present with atypical features. CT scan is regarded as the most accurate test to diagnose appendicitis [3]. Mocucele refers to distention of the appendix with sterile mucus. Some cases are due to mucinous cystadenoma or cystadenocarcinoma [1]
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