ABSTRACT This case reports a 35-year-old man with recurrent right lower quadrant (RLQ) pain initially suggestive of acute appendicitis who was diagnosed with functional abdominal pain syndrome after negative imaging and colonoscopy. Because of persistent pain, he underwent a diagnostic laparoscopy and appendectomy, where an appendiceal neuroma was diagnosed; this led to complete symptom resolution. This case highlights the importance of considering appendiceal neuroma in the differential for unexplained appendicitis-like RLQ pain, particularly when standard workups are inconclusive. The resolution of symptoms postsurgery suggests that exploratory surgery should be considered in patients with severe and persistent RLQ pain, even with negative imaging.
Herblum et al. (Sun,) studied this question.