Appendicitis must be considered as part of the differential diagnosis in any patient who presents to the ED with abdominal pain, including those whose pain begins after sustaining blunt trauma to the abdomen. This case highlights a patient who developed acute appendicitis following blunt trauma to the abdomen sustained during a motor vehicle accident. Treatment includes intravenous antibiotics and surgical consultation for appendectomy. Imaging with ultrasound or computed tomography is recommended if the history and physical do not reveal an acute surgical indication. Evaluation for traumatic appendicitis requires a careful history and physical exam. Presentation typically mirrors that of non-traumatic appendicitis with nausea, anorexia, fever, and right lower quadrant abdominal tenderness and/or peritonitis. These include direct compression/crush injury, shearing injury, or from indirect obstruction of the appendiceal lumen by an ileocecal hematoma or traumatic impaction of stool into the appendix. The pathophysiology is uncertain but likely results from several mechanisms, either in isolation or combination. Intestinal injury and hollow viscus injury following blunt abdominal trauma are well reported in the literature but traumatic appendicitis is much less common. Appendicitis typically results from obstruction of the appendiceal lumen, although trauma has been reported as an infrequent cause of acute appendicitis. Appendicitis is a frequently encountered surgical problem in the Emergency Department (ED).
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