Urological manifestations of acute appendicitis.

The diagnosis of appendicitis may be difficult to establish even for the experienced surgeon. Considerable variability in presenting symptoms and signs, resulting in part from the numerous locations in which the appendix may be found, contributes to diagnostic insecurity. Appendicitis that mimics acute disorders of the genitourinary tract is a rare cause of diagnostic confusion. The association of appendicitis with abnormal urinary sediment or ureteral obstruction has been reported previously. We report 3 cases of proved appendicitis that presented with other symptoms suggestive of acute urological disorders (gross hematuria, acute prostatis and acute pyelonephritis). While gross hematuria caused by appendicitis has been reported previously, cases of appendicitis mimicking acute prostatitis or rupture of a renal calix with extravasation of urine following ureteral obstruction have not been described. Recognition of unusual manifestations of appendicitis is essential in current surgical practice. Appendicitis should be included in the differential diagnosis of acute urological disorders.