Discuss why R.O.'s presenting clinical manifestations make diagnosis more difficult. Identify
two other possible diagnoses.
What will be an ideal response?
Appendicitis can mimic many other intra-abdominal conditions. Her clinical manifestations—
abdominal pain, anorexia, vomiting, and fever—are common to other gastrointestinal conditions.
Gastroenteritis, either viral or bacterial, and urinary tract infections (UTIs) are conditions that
share similar clinical manifestations associated with appendicitis. Other conditions that might
be considered by the PCP include irritable bowel disease (IBD), Crohn disease, ulcerative colitis,
intussusception, intestinal obstruction, Hirschsprung disease, hepatitis, irritable bowel syndrome
(IBS), pelvic inflammatory disease (PID), and recurrent abdominal pain. Adolescent females should
have a serum human chorionic gonadotropin (HCG) drawn to rule out ectopic pregnancy.
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