The diagnosis and treatment of lesions of the right lower quadrant do not as a rule present difficult clinical problems. But every so often patients with a disease condition in this region are encountered who not only have run the gamut of diagnostic procedures for years but also have undergone surgical intervention only to have a questionably diseased appendix removed.
In view of the fact that appendicitis is such a comparatively common disease, it is not surprising that the symptoms referable to the right lower quadrant are often ascribed to an inflammatory process of the appendix when in reality the lesion is in the cecum or the terminal part of the ileum. For example, it is a well known clinical observation that not infrequently patients with nonspecific granuloma or regional ileitis have an appendectomy performed and subsequently, when the symptoms recur, a pathologic process in the ileum is discovered. Patients
PICKHARDT OC, RAFSKY HA. PROBLEMS PRESENTED BY LESIONS OF THE RIGHT QUADRANT. JAMA. 1937;109(25):2048-2053. doi:10.1001/jama.1937.02780510022007