Acute abdomen due appendicitis with atypical presentation leading to shock in an obese patient and with chronic liver disease

Alexandra Damasio Todescatto, Felipe Ferreira Laranjeira, Júlia De Gasperi, Davyd Emaanuel Fin de Lehmann, Bruna Schmitt de Lacerda, Diego Carrao Winckler, Ricardo Breigeiron

Abstract


AIMS: To expose a case of acute abdomen due to appendicitis whose diagnosis was difficult and complicated because of the patient's profile and his comorbidities.

CASE DESCRIPTION: Male patient, 52 years old, superobese, smoker and with chronic liver disease, complaining of acute abdominal pain in the right hypochondrium, vomiting and low diuresis. Initially with no signs of peritoneal irritation, the patient was medically managed, but presented worsening of clinical status, progressing to shock and cardiac arrest. The investigation by laparotomy found acute appendicitis, collateral circulation and liver cirrhosis.

CONCLUSIONS: Acute abdomen has great impact on emergency care and, since it comprises several clinical situations, knowing and suspecting its main causes and its atypical presentations becomes essential, mainly in cases of difficult diagnosis.

Keywords


ABDOMINAL PAIN; ACUTE ABDOMEN; APPENDICITIS; SCHOCK, SEPTIC.



DOI: http://dx.doi.org/10.15448/1980-6108.2014.1.16339

This journal is a member of COPE (Committee on Publication Ethics) and follow the principles recommended by this international reference organization on integrity and ethics in scientific publication.

Licença Creative Commons
Except where otherwise noted, the material published in this journal is licensed under a Creative Commons Attribution 4.0 International licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original publication is properly cited.
Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.

 
 Member of OASPA

Copyright: © 2006-2019 EDIPUCRS