Intercostal Neuritis Masquerading as Acute Appendicitis: A Case Report

Abstract

Abdominal pain is a common complaint among Emergency Department (ED) patients and accounts for approximately 10% of all visits. While some presentations are classic, making diagnosis and treatment expeditious, other presentations require time-intensive work-ups that yield no etiology in nearly 25%. The Emergency Physician (EP) is tasked to maintain a broad differential while ruling out surgical conditions such as acute appendicitis. Within this differential is abdominal wall pathology. We present a case of a 28 year-old female who presented with right lower quadrant pain, was diagnosed with intercostal neuritis and discharged with a non-steroidal anti-inflammatory drug (NSAID) and appendicitis precautions. Ultimately, timely diagnosis of these less emergent pathologies can improve patient satisfaction, prevent unnecessary tests and provide targeted treatment modalities.