Hi,
Thanks for writing in to us.

While the clinical diagnosis may be straightforward in patients who present with classic signs and symptoms, atypical presentations may result in diagnostic confusion and delay in treatment. Helical computed tomography (CT) and graded compression color Doppler ultrasonography (US) are highly accurate means of establishing the diagnosis.

If appendicitis has been ruled out on CT scan , it is almost certain that he does not have that condition.

Other conditions presenting like acute appendicitis include the following:
1. Mesenteric adenitis has been reported as the second most common cause of right lower quadrant pain after appendicitis.

2. Infectious enterocolitis can cause mild symptoms resembling common viral gastroenteritis.

3. Epiploic appendages are small adipose protrusions from the serosal surface of the colon. An epiploic appendage may undergo torsion and secondary inflammation, causing focal abdominal pain that simulates appendicitis when located in the right lower quadrant.

4. Omental infarction has a pathophysiology and clinical presentation similar to that of epiploic appendagitis, with the infarcted fatty tissue being a right-sided segment of the omentum.

5. Right-sided colonic diverticulitis may clinically mimic appendicitis or cholecystitis, although the patient's history is generally more protracted.

Clinical examination by surgeon is most important to differentiate causes of the pain along with CT scan findings.

Hope this helps

Hi,

Thank you for your query on Healthcare Magic.

Pain in the abdomen which present like appendicitis pain are renal colic, infection at ileocecal region, and mesenteric lymphadenitis.

But most of these problems will be detected by CT scan abdomen.

Urine to be tested for any urine infection.

Some times abdominal migraine will present with abdominal pain.

Ask him to consult the physician to evaluate for the other causes of pain abdomen.

Hope I have answered your query.

Regards.

Hi ! Appendicitis is more of a clinical diagnosis than by investigations. Ultrasound or a CT scan may or may not be conclusive, but may be supportive only.
Other possiblities are a right ureteric calculi with intermittent blockage in the urine flow,which may give rise to such pain, and ultrasound is a better modality for a stone than the CT scan. Your family physician may advise you to go for a urine test in case he suspects a urinary tract infection associated with a calculi.
Did you boy friend had any history of testicular pain recently ? In that case it could be a radiated pain related to inflammation in the right testicle. Your treating doctor has to examine him clinically to exclude it.
Also if he has a habit of eating outside frequently, and had a history of any bowel disorder, one may think of an attack of colitis as well.He may have to go for a routine stool test in that case and have appropriate antibiotics for that.
Apart from this, there are some chronic inflammatory disorders which may give rise to such symptoms, but I do not want to confuse you more on all these.
Last but not the least, if the problem continues, then I would suggest you to take appointment with a general surgeon, who after clinically examining you and based on the investigations, may arrive at a conclusion and manage further. In case of non conclusion of the diagnosis, he may even suggest you either for a endoscopic examination or a diagnostic laparoscopy to arrive at a diagnosis, as removing a normal appendix may not cause any such grave problem, but leaving a diseased appendix behind by chance may lead to a lot of problem.
Wishing your boy friend an early recovery. Good luck.