Appendicitis better diagnosis
John, aged 47, had sudden onset of midabdominal pain and nausea. Examination at a local emergency department (ED) revealed a diffusely tender abdomen without rebound or guarding. The ED physician sent John home with an anti-emetic and an H2 blocker. After a day, John’s pain decreased, but he developed a low-grade fever. On re-evaluation, an abdominal CT scan showed a retrocecal appendix with a small abscess, indicating appendicitis with perforation.
Appendicitis results from obstruction and subsequent inflammation of the vermiform appendix. Accumulating secretions within the obstructed appendix lead to inflammation and ischemia, which can progress to necrosis and perforation. While appendicitis can occur at any age, it is most common in children (though rare in those younger than 2 years) and in people in their 20s and 30s.
When appendicitis presents with classic symptoms, diagnosis is not difficult. However, a significant number of patients, like John, present with atypical appendicitis symptoms . Prompt recognition of these presentations is important for early diagnosis and treatment.