Acute Appendicitis: “To operate, or not to operate? That is the question…”

 

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A pediatric hospitalist from the United States recently shared on SERMO a case involving a patient whose appendicitis took a turn for the worse after a conservative approach was taken.

This 16-year-old patient was asymptomatic until 11/25 when she developed “tummy cramps.” She awoke the following morning with sharp periumbilical pain rated 6-7/10. The pain worsened on 11/28 to an 8/10 and became localized to right lower quadrant. She was taken to the ER and was noted to be non-toxic and looking really well. She was diagnosed clinically (RLQ tenderness) and radiologically (after positive abdominal ultrasound) with Acute Appendicitis without perforation (no fever, normal WBC count & CRP at that time). Surgeon on call decided not to operate in view of new trends favoring conservative approach…

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Are you a physician? Join SERMO or login to find out how the “conservative approach” panned out for this particular patient, and to weigh in on whether or not you agree with new trends.

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