Acute appendicitis is sudden inflammation of the appendix, usually caused by an obstruction. It is the most common cause of acute abdominal pain in the UK, meaning that about 10% of the population will develop appendicitis at some point – most commonly between the ages of 10-20. If it is not suspected, or diagnosed promptly, it can rupture and cause a severe, life threatening infection. For this reason, it should always be at the front of any physician or surgeon’s mind.
In one recent case, a patient was admitted to an A+E department with a short history of diarrhoea and vomiting. He was promptly and thoroughly assessed and was diagnosed as having a case of gastroenteritis, with the warning that if his symptoms deteriorated, he should seek further medical advice.
Unfortunately, by the next day, the patient’s symptoms had worsened and he was feeling feverish and had developed severe abdominal pain. When he saw his GP, and informed him of the diagnosis, the doctor was falsely reassured by the previous findings and recommended analgesia and to drink more fluids. A urine test showed blood which may have indicated a urinary tract infection, so antibiotics were also prescribed. At no point did the doctor repeat the abdominal exam which may have provided valuable information.
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