Apendicitis aguda sin dolor o "El paraíso de los tontos". Caso clínico

Abstract

The diagnosis of acute appendicitis has been based on the presence of right lower quadrant pain and guarding. Occasionally, the pain disappears, even in the presence of a continuing appendicular process. This phenomenon is called "the fools' paradise". We report two male patients aged 19 and 17 years with an acute appendicitis confirmed by an abdominal ultrasound in one and an abdominal CAT scan in the other, in whom the abdominal pain disappeared during the evolution. Despite of the absence of pain, both were operated, based on imaging and laboratory studies, confirming the presence of an inflamed appendix (Rev Méd Chile 2008; 136: 1559-63).