Missed appendicitis after self-induced abortion.

Abstract

Female lower abdominal pain poses diagnostic difficulties for clinicians, especially when little more than the history and physical examination are available. A girl presented with constant lower abdominal pain after taking misoprostol for pregnancy termination. She was eventually referred to a rural District Hospital, where a laparotomy demonstrated acute appendicitis. After treating herself for a self-diagnosed pregnancy with illegally provided misoprostol, this patient presented with persistent lower abdominal pain. The differential diagnosis included ectopic pregnancy and all other causes of female abdominal pain. Yet diagnosing two diseases in the same anatomical area at the same time contradicts diagnostic parsimony. System problems in resource-poor areas can limit access to healthcare services and encourage dispensing potentially dangerous medications without clinicians' authorization. It is dangerous to rely on patients' self-diagnoses while neglecting other diagnoses. More than one diagnosis may be needed to explain temporally and anatomically related symptoms.

• Authors: Damien Punguyire, Victor Kenneth Iserson
• Journal: The Pan African medical journal (Pan Afr Med J) Vol. 10 Pg. 38 ( 2011) ISSN: 1937-8688 [Electronic] Uganda
• PMID: 22187620 (Publication Type: Case Reports, Journal Article)

Chemical References

• Abortifacient Agents, Nonsteroidal
• Misoprostol

Topics

• Abdominal Pain (chemically induced, diagnosis)
• Abortifacient Agents, Nonsteroidal (adverse effects)
• Abortion, Criminal
• Appendicitis (diagnosis)
• Diagnostic Errors
• Female
• Humans
• Misoprostol (adverse effects)
• Pregnancy
• Young Adult