Sound Bite 13 - Perforated Appendicitis (Paeds)
Author: Dr Nick Mani
A 14 yr old boy arrives at the Emergency Department with acute lower right abdominal pain that initially started in the centre, associated with vomiting.
He has a low grade fever, voluntary guarding, and RIF tenderness ++. Examination of the rest of abdomen, hernial orifices, and genital/scrotum/testicle exam is normal.
You decide to perform POCUS of appendix as an extension of your standard clinical assessment: -
Clips- Free fluid adjacent to the caecum, the appendix not identified in multiple views
Case Resolution
The laboratory bloods that come back after you completed your assessment demonstrate a raised CRP.
The enhanced clinical assessment by POCUS allowed timely diagnosis, management and urgent referral of suspected perforated appendicitis. The child underwent surgery, which confirmed the diagnosis with a good outcome.
Take Home Message
POCUS of the appendix can be rapidly performed to augment the standard clinical assessment for suspected appendicitis, ultimately improving patient care and safety.
