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Abdominal Pain 

Abdominal Pain
Abdominal Pain
Acute Care Casebook

Elizabeth DeVos


This case demonstrates a common presentation of appendicitis including frequent signs and symptoms and classic examination findings. Options for diagnostic imaging are reviewed. Clinical decision scores may assist in risk stratification, which may be particularly useful in austere or low-resource settings. The discussion introduces the concept of “antibiotics first” treatment for appendicitis including a discussion of patients who are poor candidates for such treatment, risks for need of future operative management, and proposed treatment protocols. While surgical management remains the standard of care in the United States, this case discusses potential utility for an “antibiotics first” protocol when definitive surgical treatment is not readily available.

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