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©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Mar 21, 2008; 14(11): 1795-1796
Published online Mar 21, 2008. doi: 10.3748/wjg.14.1795
Published online Mar 21, 2008. doi: 10.3748/wjg.14.1795
Perforated appendicitis masquerading as acute pancreatitis in a morbidly obese patient
Michael J Forster, Jacob A Akoh, Department of Surgery, Plymouth Hospitals NHS Trust Plymouth, PL6 8DH, United Kingdom
Author contributions: Forster MJ summarized the case report; Akoh JA wrote the paper.
Correspondence to: Jacob A Akoh, Level 03, Derriford Hospital, Plymouth PL6 8DH, United Kingdom. iacob.akoh@phnt.swest.nhs.uk
Telephone: +44-2763619
Fax: +44-2774651
Received: November 1, 2007
Revised: January 28, 2008
Published online: March 21, 2008
Revised: January 28, 2008
Published online: March 21, 2008
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.
Keywords: Morbid obesity; Perforated appendicitis; Pneumonia; Serum amylase