Perforated appendicitis masquerading as acute pancreatitis in a morbidly obese patient.

Abstract

Diagnosis and treatment of common conditions in morbidly obese patients still pose a challenge to physicians and surgeons. Sometimes too much reliance is put on investigations that can lead to a misdiagnosis. This case demonstrates an obese woman admitted under the medical team with a presumed diagnosis of pneumonia, who was later found to have an acute abdomen and raised amylase, which led to an assumed diagnosis of pancreatitis. She died within 24 h of admission and post mortem confirmed the cause of death as systemic sepsis due to perforated appendicitis, with no evidence of pancreatitis. Significantly elevated serum amylase level may occur in non-pancreatitic acute abdomen.

• Authors: Michael-J Forster, Jacob-A Akoh
• Journal: World journal of gastroenterology (World J Gastroenterol) Vol. 14 Issue 11 Pg. 1795-6 (Mar 21 2008) ISSN: 1007-9327 [Print] United States
• PMID: 18350613 (Publication Type: Case Reports, Journal Article)

Chemical References

• Amylases

Topics

• Abdomen, Acute (enzymology, etiology)
• Acute Disease
• Amylases (blood)
• Appendicitis (complications, diagnosis, enzymology)
• Diagnosis, Differential
• Diagnostic Errors (prevention & control)
• Fatal Outcome
• Female
• Humans
• Middle Aged
• Obesity, Morbid (complications, enzymology)
• Pancreatitis (complications, diagnosis)
• Peritonitis (etiology)
• Sepsis (etiology)
• Up-Regulation