Acute abdomen in a cervical spinal cord injury patient: a case report and review of the literature

Abstract

Acute abdomen, including appendicitis, is an emergent condition requiring early detection and, often, immediate surgical intervention. Although patients with spinal cord injury (SCI) have an incidence of acute abdomen similar to that of the general population, diagnosing them is even more difficult and complex than it is in the general population. Because of the disruption of normal sensory pathways, the early symptoms are subtle and physical examination of the abdomen is often not helpful. In addition, because of concomitant common conditions in SCI patients, such as urinary tract infection, atelectasis, pneumonia, and decubitus ulcer, laboratory results are not reliable. Delayed diagnoses lead to higher mortality rates among SCI patients with acute abdomen than those of the general population. We report a case of appendicitis in a patient with cervical SCI and discuss the clinical characteristics and diagnostic pitfalls of acute abdomen in SCI patients.