Two different pathologies in a single patient ,  each with almost similar manifestations could be tricky. The other day one middle aged  lady was referred to exclude Ac appendicitis. She was complaining of rt lower abdominal pain , vomiting & feverish feeling. No laboratory support was available. Scanning revealed a rt VUJ stone & also Ac appendicitis. Our old Medical College Professors used to tell us to explain patients clicical conditions in the light of a  single diagnosis. But lately I could realize a sigle disease of similar manifestation can't exclude a 2nd patology.