Acute ruptured appendicitis and peritonitis with pseudomyocardial infarction.
Liao WI, Tsai SH, Chu SJ, Hsu CW, Lin YY
Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan.
Acute abdominal conditions unexpectedly present with electrocardiographic changes. However, the presence of electrocardiographic changes and misleading clinical manifestations may obscure true etiology and delay surgical interventions. We present a patient who developed ruptured appendicitis with peritonitis manifested as acute inferior wall myocardial infarction-like electrocardiographic changes. A thorough physical examination and early echocardiographic evaluation helped to differentiate this pseudomyocardial infarction. A 64-multidetector-row computed tomography of the abdomen showed ruptured retrocecal appendicitis, and emergent appendectomy was done. Normalization of ST segments was observed after surgery.
Published 5 June 2009 in Am J Emerg Med, 27(5): 627.e5-8.
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