A case report on recurrent appendicitis: An often forgotten and atypical cause of recurrent abdominal pain

Abstract

Introduction: Recurrent appendicitis is a disease process, distinct from acute appendicitis, which occurs with an approximate incidence of 10%. This clinical entity can pose diagnostic and therapeutic dilemma for clinicians resulting in delayed diagnosis and severe complications. Presentation of case: Herein, we described a case of recurrent appendicitis with a history of 18 years of right lower quadrant (RLQ) abdominal pain with very mild tenderness that we encountered in our hospital in January 2016, which has been misjudged as other abdominal conditions and got complete relief after appendectomy. The case report could help to improve the awareness of medical practitioners who come across similar cases so that they can consider recurrent appendicitis in their differential diagnosis; and hence outline appropriate diagnosis as well as early medical interventions. Discussion: Recurrent appendicitis can be missed or delayed secondary to atypical presentation or prior treatment with antibiotics, which may lead to resolution of the infection. Missed diagnosis can lead to serious complications such as perforation, abscess formation and peritonitis. Medical practitioners who encounter patients with recurrent right flank pains with an extended duration should suspect for recurrent appendicitis and carefully analyze patient history as well as line up their diagnosis. Conclusion: Therefore, recurrent appendicitis should be considered as differential diagnosis in patients with recurring right lower quadrant abdominal pain and mild/or no tenderness.