Delayed Diagnosis of Acute Appendicitis Leading to Generalized Peritonitis and Postoperative Acute Kidney Injury: a case report

Background Delayed diagnosis of acute appendicitis can lead to severe complications, including peritonitis and organ dysfunction. Case Presentation We report a 17-year-old male initially misdiagnosed with Acute gastritis who presented two weeks later with generalized peritonitis due to perforated appendicitis. Following emergency laparotomy and appendectomy, he developed postoperative acute kidney injury. A furosemide challenge test demonstrated preserved renal function, allowing successful conservative management. The patient showed progressive clinical improvement with recovery of renal function and was discharged in stable condition. Conclusion This case highlights the consequences of delayed diagnosis and suggests a potential role for the furosemide challenge test in guiding management of postoperative acute kidney injury.