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Congenital absence of the appendix: A differential diagnosis in Right iliac fossa pain

Edward K. Yeboah, Luke L. Anthony

Am J Case Rep 2011; 12:12-13

DOI: 10.12659/AJCR.881374


Abstract: Background: Congenital absence of the appendix is very rare and is seen in 1/100,000 laparotomies. It was first described in 1718 by Morgagni, and only about 100 cases have been reported since.
Case Report: A 50-year-old indigenous Australian woman presented with a two day history of vague abdominal pain, which then localised to the right iliac fossa. Clinical examination revealed right iliac fossa tenderness and rebound tenderness. Laboratory tests showed a raised C-reactive protein and normal white cell count. She underwent exploratory laparoscopy, laparotomy where the appendix was not found. She had a Computer Tomography scan of the abdomen and pelvis followed by a colonoscopy. The diagnosis of a congenitally absent appendix was made.
Conclusions: Surgeons must be aware of this condition also exists in the population. The diagnosis must be suspected together with other differential diagnoses when the appendix is not seen or there is no evidence of appendicitis on CT scan.

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