Inferior Vena Cava Thrombosis, Appendicitis Mimic

ABSTRACT Right lower quadrant abdominal pain is a common presentation to the Emergency Department. While appendicitis is a frequently diagnosed pathology associated with this complaint, there are multiple, well-documented alternatives that must be considered. The authors present a unique case of a 2...

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Bibliographic Details
Published in:Military medicine 2023-07, Vol.188 (7-8), p.e2745-e2749
Main Authors: Kaylor, Ryan M, Gehrz, Joseph A, Gutweiler, Alex A, Cortes, James S
Format: Article
Language:English
Subjects:
Abdomen
Case reports
Pain
Thrombosis
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Summary:ABSTRACT Right lower quadrant abdominal pain is a common presentation to the Emergency Department. While appendicitis is a frequently diagnosed pathology associated with this complaint, there are multiple, well-documented alternatives that must be considered. The authors present a unique case of a 20 year old active duty male who presented with 3 days of acutely worsening right lower quadrant abdominal pain, right flank pain, and anorexia. Following a detailed work-up, computed tomography and magnetic resonance imaging (MRI) demonstrated a bland thrombus within the inferior vena cava (IVC) secondary to a vascular web. This case highlights the difficulty in astutely diagnosing appendicitis utilizing clinical examination and scoring metrics. While IVC thrombosis is a rare phenomenon, it should be considered in the emergency physician’s differential for right lower quadrant abdominal pain, particularly when additional nonspecific symptoms are present.
ISSN:0026-4075
1930-613X
DOI:10.1093/milmed/usab487