Synchronous Acute Appendicitis and Acute Cholecystitis: A Report of a Rare Case

Two of the most common emergent surgical interventions are acute appendicitis and acute cholecystitis. However, synchronous presentation is rare. In this report, we present a 29-year-old female patient with three days of worsening right lower quadrant (RLQ) pain with nausea and vomiting. Physical examination showed tenderness to palpation at the RLQ. Workup showed acute appendicitis with probable localized perforation and peri-appendiceal abscess, and CT-guided drainage was performed. The patient was discharged after four days. Seventeen days later, the patient returned to the ED with complaints of new right upper quadrant (RUQ) pain with nausea, vomiting, and loss of appetite. The ultrasound showed similar gallbladder findings with a positive sonographic Murphy's sign. A CT scan showed appendicitis and cholecystitis with gallstones and mild gallbladder wall thickening. The patient then had a laparoscopic cholecystectomy and appendectomy. This case report sheds new light on this rare and interesting surgical emergency.