Research Report
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World J Gastroenterol. Apr 14, 2014; 20(14): 4043-4049
Published online Apr 14, 2014. doi: 10.3748/wjg.v20.i14.4043
Acute right lower abdominal pain in women of reproductive age: Clinical clues
Sinan Hatipoglu, Filiz Hatipoglu, Ruslan Abdullayev
Sinan Hatipoglu, Department of General Surgery Unit, School of Medicine, Adiyaman University, 02040 Adiyaman, Turkey
Filiz Hatipoglu, Department of Obstetrics and Gynecology Unit, School of Medicine, Adiyaman University, 02040 Adiyaman, Turkey
Ruslan Abdullayev, Department of Anesthesiology and Reanimation Unit, School of Medicine, Adiyaman University, 02040 Adiyaman, Turkey
Author contributions: Hatipoglu S and Hatipoglu F contributed equally to this work; Hatipoglu S and Hatipoglu F designed the research; Hatipoglu S and Hatipoglu F performed the research; Hatipoglu S and Hatipoglu F contributed new reagents/analytic tools; Hatipoglu S, Hatipoglu F and Abdullayev R analyzed the data; Hatipoglu S, Hatipoglu F and Abdullayev R wrote the paper.
Correspondence to: Sinan Hatipoglu, MD, Assistant Professor, Department of General Surgery Unit, School of Medicine, Adiyaman University, Altınsehir Street, 02040 Adiyaman, Turkey. hamitsinanh@gmail.com
Telephone: +90-505-4509402 Fax: +90-416-2231693
Received: October 16, 2013
Revised: December 11, 2013
Accepted: January 3, 2014
Published online: April 14, 2014
Processing time: 180 Days and 5.2 Hours
Abstract

AIM: To study possible gynecological organ pathologies in the differential diagnosis of acute right lower abdominal pain in patients of reproductive age.

METHODS: Following Clinical Trials Ethical Committee approval, the retrospective data consisting of physical examination and laboratory findings in 290 patients with sudden onset right lower abdominal pain who used the emergency surgery service between April 2009 and September 2013, and underwent surgery and general anesthesia with a diagnosis of acute appendicitis were collated.

RESULTS: Total data on 290 patients were obtained. Two hundred and twenty-four (77.2%) patients had acute appendicitis, whereas 29 (10%) had perforated appendicitis and 37 (12.8%) had gynecological organ pathologies. Of the latter, 21 (7.2%) had ovarian cyst rupture, 12 (4.2%) had corpus hemorrhagicum cyst rupture and 4 (1.4%) had adnexal torsion. Defense, Rovsing’s sign, increased body temperature and increased leukocyte count were found to be statistically significant in the differential diagnosis of acute appendicitis and gynecological organ pathologies.

CONCLUSION: Gynecological pathologies in women of reproductive age are misleading in the diagnosis of acute appendicitis.

Keywords: Gynecological pathologies; Appendicitis; Differential diagnosis; Anamnesis; Physical examination

Core tip: Gynecological organ pathologies require to be taken into consideration when dealing with acute right lower abdominal pain in patients of reproductive age. We evaluated clinical and laboratory clues in the differential diagnosis of gynecological pathologies and acute appendicitis in patients of reproductive age. Defense, Rovsing’s sign, increased body temperature and increased leukocyte count were statistically significant in the differential diagnosis of acute appendicitis and gynecological organ pathologies. In women of reproductive age with acute abdominal pain, we should also consider the probability of gynecological pathologies, therefore, gynecological anamnesis and examination should be undertaken.