Appendicitis differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Appendicitis presents with pain near the navel, specifically the right lower quadrant of the abdomen. Because it is mainly characterized by different variants in type of abdominal pain, appendicitis must be differentiated from other diseases and disorders causing similar symptoms.

Differentiating Appendicitis from other Diseases

Since appendicitis presents as the general symptom of abdominal pain, appendicitis must be differentiated from other diseases and disorders causing similar pain and symptoms. This differentiation can be done according to age group:

In Children:

• Gastroenteritis
• Mesenteric adenitis
• Meckel's diverticulum
• Intussusception
• Henoch-Schõnlein purpura
• Lobar pneumonia

In Adults:

• Regional enteritis
• Renal colic
• Perforated peptic ulcer
• Testicular torsion
• Pancreatitis
• Rectus sheath hematoma
• Pelvic inflammatory disease
• Ectopic pregnancy
• Endometriosis
• Torsion/rupture of ovarian cyst
• Ruptured Graafian follicle

In the Elderly:

• Diverticulitis
• Intestinal obstruction
• Colonic carcinoma
• Mesenteric infarction
• Leaking aortic aneurysm.

Other Causes Mimicking Appendicitis at Any Age

In general:

• Acute Gastroenteritis
• Luminal obstruction caused by:

  • Barium
  • Fecaliths
  • Foreign body
  • Fruit seeds
  • Hypertrophy of the lymphatic tissue
  • Parasites
  • Stricture