Right lower quadrant pain in females. Is it appendicitis or gynecological?

OBJECTIVE: To determine if a gynecological consultation is needed for patients who are labeled to have acute appendicitis.

METHODS: A retrospective study carried out in Assir Central Hospital, Abha, Kingdom of Saudi Arabia. Fifteen female patients who were clinically diagnosed and operated upon for acute appendicitis were discovered intra-operatively to have unrelated gynecological lesions, are presented.

RESULTS: Histopathological reports on the removed appendices revealed 80% "normal" and 20% "mildly inflamed". Seven (46.7%) of the patients had right ovarian cysts (one of them, bilateral); 4 (26.7%), corpus luteum cysts, and 4 had bilateral salpingitis, bilateral pyosalpinx, right ovarian cyst with bilateral salpingitis and ruptured right tubal pregnancy each. The majority (60%) of the women were in the 20-30-year-age bracket.

CONCLUSION: The need for gynecological review of female patients of childbearing age presenting with lower abdominal pain is stressed. Ultrasonography is an important adjunct in improving diagnostic accuracy in such cases.