A Case of Tip Appendicitis: The Role of CT Scan

TL;DR

A rare case of tip appendicitis was diagnosed using a CT scan, highlighting its importance in identifying unusual forms of this condition.

Contribution

This case emphasizes the diagnostic value of CT imaging in detecting acute tip appendicitis, a rare variant.

Findings

CT imaging revealed mild dilation of the appendiceal tip and subtle fat stranding, indicating early tip appendicitis.

Laparoscopic appendectomy confirmed inflammatory changes at the appendiceal tip.

Tip appendicitis should be considered in the differential diagnosis of right lower quadrant pain.

Abstract

Acute appendicitis is a common cause of abdominal pain and a leading indication for surgery, especially in younger patients. While its diagnosis is often straightforward, rarer forms like acute tip appendicitis can be more difficult to detect. The growing use of CT imaging has made it easier to identify these unusual cases. A 32-year-old female patient presented with sharp, constant abdominal pain localized to the right lower quadrant and suprapubic region, with an intensity of 7/10 that worsened with oral intake. Physical examination revealed minimal tenderness in the lower quadrants, along with right adnexal tenderness, and lab results, including a negative urine pregnancy test, were unremarkable. CT imaging showed mild dilation of the appendiceal tip and subtle periappendiceal fat stranding, suggesting early tip appendicitis, while the rest of the appendix appeared normal. The patient underwent laparoscopic appendectomy, which confirmed inflammatory changes at the appendiceal tip, thus diagnosing acute tip appendicitis. This case underscores the importance of considering tip appendicitis in the differential diagnosis of right lower quadrant pain, particularly with the increasing use of CT imaging. Despite its rarity, tip appendicitis should be recognized as a potential cause with similar clinical risks as more common forms of appendicitis, including significant morbidity if not treated promptly.

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