Pain Right iliac fossa,not everyone has acute appendicitis

Objective: to evaluate various causes of acute pain in right iliac fossa (r.i.f) other than acute appendicitiis an attempt to adopt measures to minimize the rate of unnecessary appendicectomies. place of study: jinnah hospital & avicenna medical college lahore from april 2008 to august 2010. materials and methods: out of 353 patients who presented with pain r.i.f,75 patients of both genders and all ages were included in the study,in whom the diagnosis of acute appendicitis was ruled out by strong history and clinical examination as well as on exploration for suspected acute appendicitis. out of 75 patients,'42(56%) were diagnosed preoperatively being suffering from pain r.i.f of non appendiceal origin and treated conservatively,while 33(44%) were diagnosed suffering from non appendiceal r.i.f pain on exploration for appendicectomy. when appendix was found normal results: acute nonspecific mesenteric lymphadenitis was the most alternative diagnosis 14(18.67) followed by pelvic inflammatory disease 13(17.33%). right ureteric colic 9(12%),urinary tract infection 7(9.33%),ruptured functional ovarian cyst 6(8%),ruptured ectopic pregnancy 5(6.6%),meckel 's diverticulitis 5(6.67%),non specific abdominal pain 5(6.67%),gastroenteritis 4(5.33%) and amoebiasis 3(4%),ovarian cyst torsion 2(2.66%),others 2(2.66%).