berkeman
Forum Lieutenant
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Worked on a young patient the other day who was complaining of severe abdominal pain with acute onset. Pain initially was in lower back and abdomen, moving over several minutes to mainly the LLQ. LRQ was relatively pain free for most of this, including rebound palpation. All vital signs were fine, and they were perfusing fine, but they were in severe pain to the point of incapacitation.
I ruled out appendicitis as a likely cause, but ectopic pregnancy and other possible causes were enough to justify sending the patient off in an ambulance to the nearest hospital stat.
I found out later in discussions with other EMS folks that I shouldn't have ruled out appendicitis so quickly, and there was at least one other thing I could have done to be more sure. It turns out to be a pretty obscure condition, present in less than 1/10,000 people, but I know at least one friend-of-a-friend now who had this misdiagnosed...
What was I missing, and what else should I have checked before ruling out appendicitis?
http://en.wikipedia.org/wiki/Situs_inversus
.
I ruled out appendicitis as a likely cause, but ectopic pregnancy and other possible causes were enough to justify sending the patient off in an ambulance to the nearest hospital stat.
I found out later in discussions with other EMS folks that I shouldn't have ruled out appendicitis so quickly, and there was at least one other thing I could have done to be more sure. It turns out to be a pretty obscure condition, present in less than 1/10,000 people, but I know at least one friend-of-a-friend now who had this misdiagnosed...
What was I missing, and what else should I have checked before ruling out appendicitis?
http://en.wikipedia.org/wiki/Situs_inversus
.