A 21 y/o man presents to the ED with pain in right low quadrant (RLQ) , anorexia, nausea and vomiting. His abdomen is soft, with a mild tenderness in RLQ, the psoas sign is positive. The pain is aggravate by cough. You perform kindly a rectal examination with pain. 
Are this signs useful for the diagnosis of acute appendicitis?

 

 

 
 

 

 

 

 

 

Conclusion 
 
No clinical signs alone is able to rule in or out an acute appendicitis. Rectal examination, still diffused, is not of any utility. 
May we need somwthing else?
 
 
Bibliography 
 
Meta-analysis of the clinical and laboratory diagnosis of appendicitis
British Journal of Surgery 2004; 91: 28-37
R.E.B. Anderson
 
Ciro Paolillo

Leave a Reply

Your email address will not be published.

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <s> <strike> <strong>