Can herniation pit of the femoral neck mimic an acute appendicitis? A case report

Volpi, Annalisa and Pannarale, Oronzo C. and Mancusi Materi, G. and Favia, V. and Panebianco, Annunziata and Prestera, A. and Ialongo, Paolo and Giungato, S. and Lozito, R. and Palasciano, Nicola (2013) Can herniation pit of the femoral neck mimic an acute appendicitis? A case report. Il giornale di chirurgia, 34 (5/6). pp. 158-160. ISSN 1971-145X

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Although in most cases the diagnosis of acute appendicitis is straightforward, not all patients experience typical symptoms and other conditions may mimic appendicitis. In fact, 15-25% of appendectomies involve the removal of a normal appendix. To date, there is no literature evidence that herniation pit (HP) may mimic acute appendicitis. We report a case of a 30 year old woman admitted to the Emergency Department for severe, acute pain developing a few hours earlier in the lower right fossa, with irradiaton to the right thigh. She did not present any fever, nausea or vomiting, Blumberg’s sign was absent but the psoas sign and obturator sign were both positive. WBC count was 16,000/mm3 and the Alvarado score was 4. Biochemistry profile was normal. US was unclear and transvaginal ultrasound did not show any gynecological disease. CT scan showed only an herniation pit of the right femoral neck. The patient was admitted to an orthopedic ward and treated with anti-inflammatory therapy. She was discharged after 2 days without any pain and in good conditions. Our case demonstrates that herniation pits of the right femoral neck should be considered a potential cause of right lower abdominal pain mimicking acute appendicitis, particularly if the psoas sign and obturator sign are positive and the patient is physically active.

Item Type: Article
Uncontrolled Keywords: Femoral neck, Herniation pit, Acute appendicitis, Abdominal pain
Subjects: 600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 617 Rami vari della medicina; Chirurgia
Depositing User: Nadia Del Gobbo
Date Deposited: 12 Sep 2019 12:29
Last Modified: 12 Sep 2019 12:29

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