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Appendicitis & CT

meredith mcbride trauma-list@trauma.org
Wed, 23 Apr 2003 18:01:57 -0700 (PDT) 

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O dear, are we rehashing this again? No, as I answered previously (see below), I don't bring them back for re-examination. In fact, I highlighted the point with an anecdote about the redundancy of CT in that scenario. Cheers, Meredith Avi Roy Shapira <avir@bgumail.bgu.ac.il> wrote:
Have you ever sent them home with a negative CT? I doubt it.


meredith mcbride <mmcbridemd@yahoo.com> wrote:
I have and do. Actually that is the recommended practice, barring the need for IV pain control, rehydration or additional testing. On one occasion I was still concerned and had the patient return the next morning for re-examination - at which time I took out an acutely inflamed, but not perforated appendix. Obviously CT added nothing but extra cost in that circumstance, since I wound up refusing to act on the negative findings by adding my own serial examination.  Typically I've been able to release the patient to their own recognizance. Return if symptoms persist or worsen, otherwise no follow up, or return to outpatient clinic as needed.  


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<DIV>
<DIV>O&nbsp;dear, are we rehashing this again? No, as I answered previously (see below), I don't bring them back for re-examination. In fact, I highlighted the point with an anecdote about the redundancy of CT in that scenario.</DIV>
<DIV>&nbsp;</DIV>
<DIV>Cheers, Meredith</DIV>
<DIV>&nbsp;</DIV>
<DIV><B><I>Avi Roy Shapira &lt;avir@bgumail.bgu.ac.il&gt;</I></B> wrote:</DIV>
<BLOCKQUOTE style="PADDING-LEFT: 5px; MARGIN-LEFT: 5px; BORDER-LEFT: #1010ff 2px solid">
<P>Have you ever sent them home with a negative CT? I doubt it.</P>
<P><BR><B><I>meredith mcbride &lt;mmcbridemd@yahoo.com&gt;</I></B> wrote:</P></BLOCKQUOTE>
<BLOCKQUOTE style="PADDING-LEFT: 5px; MARGIN-LEFT: 5px; BORDER-LEFT: #1010ff 2px solid">
<DIV>I have and do. Actually that is the recommended practice, barring the need for IV pain control, rehydration or additional testing. On one occasion I was still concerned and had the patient return the next&nbsp;morning for re-examination - at which time I took out an acutely inflamed, but not perforated appendix.&nbsp;Obviously&nbsp;CT&nbsp;added nothing but extra cost&nbsp;in that circumstance, since I wound up refusing to act on the negative findings by adding my own serial examination. </DIV>
<DIV>&nbsp;</DIV>
<DIV><STRONG>Typically I've been able to release the patient to their own recognizance. Return if symptoms persist or worsen, otherwise no follow up, or&nbsp;return to outpatient clinic as&nbsp;needed. </STRONG></DIV>
<DIV><STRONG></STRONG>&nbsp;</DIV></BLOCKQUOTE></DIV><p><br><hr size=1>Do you Yahoo!?<br>
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