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Cite this article:
Damien Punguyire, Kenneth Victor Iserson. Missed appendicitis after self-induced abortion. The Pan African Medical Journal. 2011;10:38 Key words: Appendicitis, misdiagnosis, abortion, pregnancy, misoprostol Permanent link: http://www.panafrican-med-journal.com/content/article/10/38/full Received: 09/05/2011 - Accepted: 11/09/2011 - Published: 13/11/2011 © Damien Punguyire et al. The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
Missed appendicitis after self-induced abort
Damien Punguyire1, Kenneth Victor Iserson2,&
1Kintampo Municipal Hospital, Kintampo, Ghana, 2Department of Emergency Medicine, The University of Arizona, 4930 N. Calle Faja, Tucson, AZ, USA
&Corresponding author
Kenneth Victor Iserson, Department of Emergency Medicine, The University of Arizona, 4930 N. Calle Faja, Tucson, AZ, USA
Female lower abdominal pain poses diagnostic difficulties for clinicians, especially when little more than the history and physical examination are available. A girl presented with constant lower abdominal pain after taking misoprostol for pregnancy termination. She was eventually referred to a rural District Hospital, where a laparotomy demonstrated acute appendicitis. After treating herself for a self-diagnosed pregnancy with illegally provided misoprostol, this patient presented with persistent lower abdominal pain. The differential diagnosis included ectopic pregnancy and all other causes of female abdominal pain. Yet diagnosing two diseases in the same anatomical area at the same time contradicts diagnostic parsimony. System problems in resource-poor areas can limit access to healthcare services and encourage dispensing potentially dangerous medications without clinicians’ authorization. It is dangerous to rely on patients’ self-diagnoses while neglecting other diagnoses. More than one diagnosis may be needed to explain temporally and anatomically related symptoms.
