Appendicitis: a traumatic etiology

Background: Blunt abdominal trauma as a cause of acute appendicitis has only been rarely reported in literature. However, controversy exists as to whether the diagnosis of appendicitis in a traumatic setting is a causal or coincidental finding. Case Report: A 22 year old, previously fit and healthy male, fell from a height of 3 meters landing onto his right side onto a concrete floor. Primary and secondary survey revealed right upper quadrant tenderness on examination and soft tissue swelling of the right shoulder. CT scan of the abdomen/pelvis for persistent and worsening abdominal pain revealed acute appendicitis with the distal tip in the right upper quadrant. Laparoscopic appendectomy confirmed an inflamed, retro-caecal appendix with the tip lying under the inferior edge of the liver. Final histopathology demonstrated active inflammatory changes consistent with acute appendicitis. Conclusion: Unrecognized or untreated acute appendicitis can lead to significant morbidity and potentially mortality. Physicians and surgeons alike should be aware of the potential for patients with blunt abdominal trauma to have this condition to enable rapid treatment and appropriate surgical opinion.