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Near miss abdominal pain
  1. Nyan Phone Tint1 and
  2. Hamzah Hussain2
  1. 1Acute Medicine, United Lincolnshire Hospitals NHS Trust, Lincoln, UK
  2. 2University of Nottingham, Nottingham, Nottinghamshire, UK
  1. Correspondence to Dr Nyan Phone Tint; nyanphonetint{at}


An 18-year-old adolescent with intermittent colicky abdominal pain for 4 months was admitted to a Medical Emergency Assessment Unit for further investigation of possible colitis, after being reviewed by a surgeon in Accident and Emergency. Initially he was treated for a urinary tract infection, however a CT of the abdomen revealed appendicular perforation with pelvic abscess formation. The patient required an urgent laparoscopy and was discharged without complications. Typically, appendicitis is an acute surgical problem whereas chronic abdominal pain is routinely considered a medical problem. This case demonstrates the importance of maintaining acute causes as part of the differentials list in young patients with unexplained recurrent abdominal pain as well as justifying the early use of CT when there is ambiguity surrounding a diagnosis.

  • general practice / family medicine
  • gastrointestinal surgery
  • primary care
  • somatoform disorders
  • inflammatory bowel disease

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  • Contributors NPT clerked the patient and involved in his care. HH and NPT both contributed to the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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