A CHANCE OF MISDIAGNOSIS BETWEEN ACUTE APPENDICITIS AND RENAL COLIC

The symptoms of right-sided renal colic mimic sometimes acute appendic itis. A prospective comparative study of 188 patients with ureteral st one and 188 patients with acute appendicitis was performed to evaluate the features of differential diagnosis. Appendicitis caused more ofte n nausea (81 vs 11%), fever and localized pain in the McBurney (97 vs 59%) than renal colic. The patients with ureteral stone had tenderness in 16% in the right lower quadrant. The mean values of C-reactive pro tein (41 mg/l) and blood leukocytes (14 x 10(9)/l) were elevated in ap pendicitis, but not in renal colic (14 mg/l and 10 x 10(9)/l). Urinana lysis revealed red cells in 92% of ureteral stones compared with 26% i n appendicitis. Only one of 188 patients with apppendicitis was first misdiagnosed to have renal colic. A mistake of appendicitis for ureter al stone is clinically rare occurring only once or twice per year in t he hospital where 700-800 emergency appendectomies are annually perfor med.