Perforated Duodenal Ulcer Presenting As Acute Appendicitis

Abstract

Background: Acute appendicitis has a lot of differential diagnoses. However, when there is perforated duodenal ulcer with the contents tracking into the right iliac fossa, it is often extremely difficult to distinguish this condition from acute appendicitis.
Aims of study: To evaluate the diagnostic dilemma encountered in attempting to differentiate between perforated duodenal ulcer (with gastric contents tracking into the right iliac fossa) and acute appendicitis.
Patients and methods: The case files over a 5 year period of patients who were initially diagnosed as acute appendicitis, but found at operation to have perforated duodenal ulcer were reviewed.
Results: There were 5 patients (3 males and 2 females) who were diagnosed to have appendicitis but at operation they were found to have perforated duodenal ulcer. The age range was between 33 and 82 years with a mean of 64.5years. Only two patients had a history of recurrent epigastric pain prior to presentation.
Conclusion: It is often difficult to distinguish perforated duodenal ulcer when the contents track into the right iliac fossa from acute appendicitis.


Sahel Medical Journal Vol. 11 (2) 2008: pp. 52-56