Perforated Appendicitis Masquerading as Bilateral Tubo-Ovarian Abscess

Acute appendicitis is a highly common cause of abdominal pain that presents with nausea and vomiting, characteristic physical exam findings, and imaging evidence of appendiceal inflammation. In the absence of these signs, diagnosis can be difficult. This case report demonstrates an uncommon presentation of appendicitis that led to a delay in diagnosis and aims to discuss the ways in which similar misdiagnoses can be avoided for clinicians in the future.