Appendicitis differential diagnosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Farwa Haideri [2]
Overview
Appendicitis must be differentiated from other causes of abdominal pain such as acute gastroenteritis and luminal obstruction. Age group can be another factor used to differentiate appendicitis.
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 four categories: surgical, urological, gynaecological, and medical.[1]
Surgical
- Intestinal obstruction
- Intussusception
- Acute cholecystitis
- Perforated peptic ulcer
- Mesenteric adenitis
- Colonic/appendicular diverticulitis
- Pancreatitis
- Rectus sheath hematoma
Urological
- Right ureteric colic
- Right pyelonephritis
- Urinary tract infection
Gynaecological
- Ectopic pregnancy
- Ruptured ovarian follicle
- Torted ovarian cyst
- Salpingitis/pelvic inflammatory disease
Medical
- Gastroenteritis
- Pneumonia
- Terminal ileitis
- Diabetic ketoacidosis
- Porphyria
Other Causes Mimicking Appendicitis at any Age
In general, Acute Gastroenteritis can often be mistaken for appendicitis. Luminal obstructions can also mimic signs of appendicitis.[2] In particular, luminal obstruction caused by:
- Barium
- Fecaliths
- Foreign body
- Fruit seeds
- Hypertrophy of the lymphatic tissue
- Parasites
- Stricture
In Children
- Mesenteric adenitis
- Meckel's diverticulum
- Intussusception
- Henoch-Schõnlein purpura, and lobar pneumonia
In Adults
- Renal colic
- Perforated peptic ulcer
- Testicular torsion
- Pancreatitis
- Pelvic inflammatory disease
- Ectopic pregnancy
- Endometriosis
- Torsion/rupture of ovarian cyst
In Elderly Patients
- Diverticulitis
- Intestinal obstruction
- Colonic carcinoma
- Mesenteric infarction
- Leaking aortic aneurysm