Next step: Abdominal CT or go to the OR and perform an appendectomy?
UW says go to the OR; Crush says do an Abdominal CT to confirm.
UW says go to the OR; Crush says do an Abdominal CT to confirm.
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Step II Appendicitis Question
Started by Doctor4Life1769
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This is traditionally a clinical diagnosis, so the answer is go to the OR. The only time the books would recommend you need a CT is if you're unsure of the dx (differentiate from a Crohns flare up, PID).
Of course in this day and age the ER orders a CT before the patient even gets through the door.
Thanks man!
I figured the next step would be the OR; however I read conflicting info from Crush ... and from rotations (like you said), the ED always does an abdominal/pelvic CT.
So for the purpose of the exam, I'll go with the OR.
I figured the next step would be the OR; however I read conflicting info from Crush ... and from rotations (like you said), the ED always does an abdominal/pelvic CT.
So for the purpose of the exam, I'll go with the OR.
In a patient without a history of chronic diarrheal illness (Chron type picture), by doing a simple history and physical exam there is really nothing else it could be in a young male. The CTs are for the patients that the diagnosis is not clear. Studies have been done to show that being more aggressive and taking out more appendices than needed is better on the population scale as it saves the real cases from becoming more severe by the time surgery finally happens. Though as said previously the ED usually orders it on everyone.
