Appendix Question - john004

[ArchivalUser]

Man comes to the physician with appendicitis symptoms, left shift, fever, BUT the appendix is not visualized on CT/sonogram. What is the next step in management?

1) appendectomy
2) observation

[ArchivalUser]

appendectomy

[ArchivalUser]

Hmm,

I figured since this looks like an atypical presentation since the appendix is not visualized, observation would be the correct option.

[ArchivalUser]

Apendicitis is a clinical Dx, if there is classic presentation, immediate apendicectomy to prevent rupture of appendix.

nonclassic findings, delayed presentation (>5d), equivocal findings...perform CT/US,

Delayed presentation....if u find abscess on CT/US.....IV hydration, Antibiotics, bowel rest......Interval appendicectomy(6-8 weeks later).

[ArchivalUser]

abscess should be drained percutaneously