• Ryan M Kaylor, Joseph A Gehrz, Alex A Gutweiler, and James S Cortes.
• Department of Emergency Medicine, Naval Medical Center, San Diego, CA 92134, USA.
• Mil Med. 2021 Dec 4.

AbstractRight lower quadrant abdominal pain is a common presentation to the Emergency Department. While appendicitis is a frequently diagnosed pathology associated with this complaint, there are multiple, well-documented alternatives that must be considered. The authors present a unique case of a 20 year old active duty male who presented with 3 days of acutely worsening right lower quadrant abdominal pain, right flank pain, and anorexia. Following a detailed work-up, computed tomography and magnetic resonance imaging (MRI) demonstrated a bland thrombus within the inferior vena cava (IVC) secondary to a vascular web. This case highlights the difficulty in astutely diagnosing appendicitis utilizing clinical examination and scoring metrics. While IVC thrombosis is a rare phenomenon, it should be considered in the emergency physician's differential for right lower quadrant abdominal pain, particularly when additional nonspecific symptoms are present.© The Association of Military Surgeons of the United States 2021. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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