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December 10, 1982

Deep-Vein Thrombosis Mimicking Acute Appendicitis: A Complication of Swan-Ganz Catheterization

Author Affiliations

From the Divison of Trauma Surgery, Henry Ford Hospital, Detroit.

JAMA. 1982;248(22):3010-3011. doi:10.1001/jama.1982.03330220054037

IN THE very young and the elderly, acute appendicitis commonly has an atypical presentation and a high perforation rate.1 It represents a difficult clinical challenge. The surgical and nonsurgical conditions that mimic acute appendicitis are well known.2 The overall rate of a normal appendix at appendectomy is 20%, and the rate is much higher in women.1 In highrisk patients, particularly those with a history of recent myocardial infarction or other serious illnesses, a correct preoperative diagnosis is of the utmost importance because unnecessary surgery carries with it a substantial morbidity and mortality for these patients.

Recent literature has incriminated the Swan-Ganz catheter and other invasive intravascular devices in the development of venous or arterial thrombosis. Ileofemoral venous thrombosis can mimic the symptoms of acute appendicitis, and it should be included in the differential diagnosis of right lower quadrant abdominal pain. A complete history and careful physical examination