Nov 30, 2009 11:35 am US/Eastern
Dr. Mallika's Files: From Belly Pain To The O.R.
Each week Dr. Mallika Marshall shares cases based on true stories from a local urgent care clinic, exclusively on wbztv.com. Names and identifiable characteristics of patients have been omitted or changed to protect patient privacy.
This Week's Case:
A 14-year-old boy is brought to clinic by his parents for belly pain. He was feeling fine the night before but woke up with pain around his belly button that has grown in intensity. He vomited twice and still feels nauseated. He hasn't wanted anything to eat or drink. He has had no fever, diarrhea, problems urinating, rash or cold symptoms. No one else in the family is sick.
On exam, the child's vitals signs are normal. He is lying quietly on his side, looking slightly pale. When asked to roll over onto his back, he grimaces in pain. He recoils during the abdominal exam and asks me not to touch his stomach. "It hurts," he says.
The patient undergoes a CT scan of the abdomen which shows an inflamed appendix.
Discussion
This child suffered from appendicitis, the most common reason for abdominal surgery in children in the United States. The appendix is a small fingerlike pouch attached to the beginning of the large intestine in the right lower quadrant of the abdomen. It is still unclear why the appendix exists but if blocked, it can become inflamed, infected and eventually burst. When this occurs, germs can spread throughout the abdominal cavity and into the bloodstream which can be very dangerous and even deadly. This is why appendicitis, or an inflamed appendix, must be immediately removed.
Someone with appendicitis typically complains of abdominal pain, which usually begins around the belly button and travels to the right lower side of the abdomen. Other common symptoms include nausea, vomiting, and low-grade fever. If you or your child develops these symptoms, you should be examined by a health professional right away.
Appendicitis is usually confirmed by ultrasound or CT scan. If suspected, the standard treatment is urgent surgical removal of the appendix, also known as an appendectomy.
Follow-up
The patient was transferred to the Emergency Room where he underwent an appendectomy that evening. He spent two days in the hospital and recovered without complication. He is now back at school and playing on the football team.
(© MMX, CBS Broadcasting Inc. All Rights Reserved.)
Click to enlarge
Stumble It!
Comments