emDocs - June 14, 2017 - Author: Chase C - Edited by: Koyfman A & Long B
"Summary:
- Abdominal pain is a common and high-risk ED complaint. Appendicitis and its mimics are often indistinguishable in their presentation.
- Appendicitis mimics requiring consideration include: ectopic pregnancy, ovarian/testicular torsion, pelvic inflammatory disease/TOA, terminal ileitis, cecal diverticulitis, cecal volvulus, gastroduodenal perforation, intussusception, Crohn’s Disease, ureterolithiasis, cholecystitis, etc.
- Every reproductive-aged female should have a pregnancy test, and males should have testicular exam when presenting with lower abdominal pain.
- Epiploic appendagitis, omental infarction, and mesenteric adenitis seen on CT are typically benign, self-limited disease processes.
- Early surgical consultation required if suspecting: ruptured ectopic, testicular/ovarian torsion, ruptured TOA, cecal volvulus, gastroduodenal perforation, adult intussusception, cholecystitis, or toxic megacolon."