Case presentation A woman of reproductive age reported recurrent episodes of right-sided abdominal and flank pain over several years. Her first episode occurred during pregnancy, when she presented to the emergency department with acute right lower quadrant pain suspicious for appendicitis. She reported no fever, nausea, vomiting, urinary symptoms, or changes in bowel habits.
Her obstetric history was uncomplicated, and the pregnancy was progressing without complications. Physical examination Hemodynamically stable Abdomen: Localized right lower quadrant tenderness No guarding, rebound tenderness, or peritonitis signs No costovertebral angle tenderness Laboratory findings White blood cell counts: Normal Inflammatory markers: Within normal limits Urinalysis: No abnormalities Abdominal ultrasound Appendix not visualized No adnexal or uterine abnormalities Mild right-sided hydronephrosis,…
