Earthguy69

Earthguy69 t1_j25aahg wrote

Reply to comment by Prinzka in TIL of Dick Roth, a swimmer who was diagnosed with appendicitis shortly before the men’s 400m individual medley in the 1964 Tokyo Olympic Games. He refused an immediate operation and instead swam in the finals, winning a gold medal. by alexjpg

No, that is literally how it is.

An ultrasound can never say it's not appendicitis. Most often an ultrasound doesn't show it.

Doing a CT scan is just giving a young patient a lot of unnecessary radiation.

The medical legal climate in the US might be different but in most places they do not do a CT scan because the presentation is so obvious.

How long have you worked in the ED?

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Earthguy69 t1_j247omu wrote

Reply to comment by Prinzka in TIL of Dick Roth, a swimmer who was diagnosed with appendicitis shortly before the men’s 400m individual medley in the 1964 Tokyo Olympic Games. He refused an immediate operation and instead swam in the finals, winning a gold medal. by alexjpg

If it's an uncomplicated appendicitis doing an xray is really unnecessary. It's lots of harmful radiation to a young person.

If the person has gone with it for days, have highly elevated inflammation markers or peritonitis, then yes doing an xray is indicated to see if there is any complications that could affect surgery.

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Earthguy69 t1_j23peth wrote

Reply to comment by Fetlocks_Glistening in TIL of Dick Roth, a swimmer who was diagnosed with appendicitis shortly before the men’s 400m individual medley in the 1964 Tokyo Olympic Games. He refused an immediate operation and instead swam in the finals, winning a gold medal. by alexjpg

>So no overlap with IBS, or excessive gas

When you palpate the abdomen there is a big difference between gas and ibs. Also the history. In modern times you can also take blood samples. Ibs or gas doesn't cause a measurable inflammation in the blood.

>, or, I don't know, an ulcer in the right place?

An ulcer the lower right abdomen (meaning large intestine distal part of the small bowel is extremely uncommon, especially in a previously healthy young male.

> Or a sports injury, muscle/tendon stuff

Again, when you palpate the abdomen an injury will be different from an appendicitis but again you can take blood samples.

> or hernia?

A hernia is something you would feel. It's also not something you get in your abdomen in that place. It's usually in other places. It's also not super common for a a young adult to suddenly develop it. If the hernia gets strangulated the pain is extreme and would warrant operation regardless.

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Earthguy69 t1_j23l3m6 wrote

Reply to comment by Fetlocks_Glistening in TIL of Dick Roth, a swimmer who was diagnosed with appendicitis shortly before the men’s 400m individual medley in the 1964 Tokyo Olympic Games. He refused an immediate operation and instead swam in the finals, winning a gold medal. by alexjpg

I mean a young guy with pain in his lower right stomach, there isn't much else that it can be.

In my hospital we wouldn't do an ultrasound, we would just operate if the blood samples also show some inflammation.

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