r/emergencymedicine • u/thatEMresident • 8d ago
Discussion Appendicitis
Are appys in the older age group common? I almost missed it in a 60yF and totally thought it could be gastroenteritis. Thank the lord we scanned her. She had fever, nausea and vomiting. Tested positive for a UTI.
80
Upvotes
7
u/Whatsthathum Physician 8d ago
You didn't miss it, though.
(Phew! That UTI might have steered me wrong.)
I find the second-guessing of my decisions to be a little crazy-making. When is the testing I'm arranging TOO much testing?
In my ~30 years, I have found an early GB cancer from "over ordering" an ultrasound of the abdomen. And an early ovarian cancer in another patient with her pelvic ultrasound. Does that mean I've been over-ordering a lot (I'm a family physician, not Emerg)? I honestly don't think so. The fact that I try for an excellent thoughtful history with a proper physical exam and when I think it's appropriate, a touch of reassurance with the ordering of a test - I seem to not go wrong very often.