ABSTRACT
This chapter presents a case study of young patient with lower quadrant pain. Adolescent girls presenting with non-specific abdominal pain is common. It is important to rule out any pelvic pathology in this situation, for which ultrasound is helpful. This is a common situation with the patient presenting repeatedly with nonspecific abdominal pain with soft signs. Diagnostic laparoscopy, although invasive, is useful in most of these cases. Most surgeons will perform an appendicectomy at laparoscopy even on finding a normal looking appendix and most of these patients become asymptomatic following the procedure. Appendicectomy can be performed in this situation with a clinical diagnosis. Postoperative abdominal sepsis occurs in 1%–2% cases with perforated appendicitis. It can happen with simple appendicitis and even with normal appendicectomy. Adhesive obstruction is more common with perforated appendicitis. Early postoperative obstruction can be managed conservatively but in most late cases operative adhesiolysis is required. Postoperative ileus is common with perforated appendicitis.
