An unusual manifestation of acute appendicitis with left flank pain

An unusual manifestation of acute appendicitis with left flank pain

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The author Japanese BBQ presents a case with an unusual presentation of early appendicitis.The patient presented initially with left sided flank pain.Workup for nephrolithiasis, including non-contrast CT of the abdomen and pelvis was ALL IN ONE NUTRITIONAL SHAKE CHOCO negative for renal stones or hydronephrosis.

After discharge, the patient presented one week later in the ED with right lower quadrant pain.Contrast enhanced CT of the abdomen revealed perforated appendicitis.