The answer to yesterday’s mystery is … appendicitis! Many readers were able to correctly guess this common ER diagnosis: Ashley, Phung, Maureen, CB, Rich S, mountain girl, F, Angelita, Erin M., Peaceable Traveller, Jessica, GetAClue, rae, Priscilla, G, sally, ColorMaven, joeyjags, Rob, Erin, Jen, JAT, Ray H, MSP, cas, Dr Sanober Jamali, JP, Not a Dr but love learning about medical stuff, Are you kidding me, Theresa, LG, cherbear, anna.
Seven percent of people will suffer from appendicitis in their lifetime. It is caused by inflammation of the appendix, a vestigial organ composed of a small outpouching of the intestine. When the pouch becomes blocked, often by stool or by compression of surrounding tissues, bacteria and immune cells multiply and cause increased pressure within the pouch. If untreated, the pressure can eventually cause the organ to burst. This can be lethal since intestinal contents can then infect the abdomen.
Our patient exhibited the “classic” symptoms and signs of appendicitis. The pain starts out around the belly button and then migrates to the lower right abdomen (called McBurney’s point). Pain is followed by loss of appetite, nausea, vomiting, and fever. Physical examination can show rebound tenderness) where pushing down on the belly is not as painful as releasing the hands off the belly) and Rovsing’s sign (pushing on the left side makes the right side hurt). CAT scans are generally only performed if the diagnosis is uncertain. Our patient’s scan shows an inflamed appendix, the gray tubular structure at 10:00 in relation to the bright white circle in the middle.
Removal of the appendix must be performed before it perforates, and it is a curative operation. It can often be done laparoscopically, with just a few tiny incisions. Are you one of the 7% who has had appendicitis? If so, did you have all of the textbook findings?