A Rare Case of Acute Appendicitis in a 21-Year-Old Male with Midsternal Chest Pain

Acute appendicitis is inflammation of the vestigial vermiform appendix. It is one of the leading causes of emergency department visits due to abdominal pain. The vermiform appendix is located at the base of cecum. The attachment does not change; however the tip may migrate to the retrocecal, subcecal, preileal, postileal and pelvic positions. Considering these normal anatomical positions, the pain presentation may vary in patients. Even though this patient presented with midsternal chest pain, which was suspicious for GERD, it was crucial to perform a thorough head-to-toe exam to discover incidental findings that the patient did not report. In this case the right lower quadrant abdominal pain was not reported, and the chest pain was most likely secondary to referred pain due to different anatomical position of the appendix