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Lower abdominal pain diagnosed as appendicitis without pain relief.

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For the past 6months i have had a sharp stabbing pain near my hip bone, which has only recently become very bad. The doctors are saying appendix, which i agree on.. I got blood tests and urine tests done.. and the urine tests said plus plus protein? Bloods were "acceptable". I also had a ultra sound which took about an hour.. and they couldn't find my appendix (but they did check my ovaries and said they are both great).The doctors have put me on strong pain killers, and pretty much told me to suck up until im vomitting.. not eating.. or pretty much can't walk. I've been to the hospital 4 times in 2 days and nothing..? three different doctors and only 1 was willing to do anything but he isn't on till weekends... at the moment I'm on anti biotics and pain killers, i wake up in severe pain duirng the night, and the only thing that seems to release the pain is a bathroom stop... HELP?!

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Category: Family Physician-GP
 26 Doctors Online


It seems like you are suffering from a retro caecal appendicitis which is difficult to be diagnosed by a USG and hence the delay in the operation. The other more plausible explanation is that the infected appendix might have already ruptured causing an appendicle abscess. Appendicle abscess are difficult to visualize in its earlier stages although it can be identified within a week of rupture.

Appendicle abscess is a collection of pus in the appendix that occurs when acute appendicitis is not managed appropriately

I would recommend the following-

1)Consult a radiologist and get an ultrasonography of the abdomen. I t will not only help in the diagnosis of the appendicle abscess but also get information on the size, shape, location of the abscess. These information help in deciding the further course of action.

2)The patient has to be started on long term antibiotic like Tab cefepim and Tab. Clindamycin. If she cannot take orally, intravenous treatment has to be started.

3)After intravenous (IV) antibiotic therapy, an interval appendectomy can be performed 4-6 weeks later.

4)Patients with a larger well-defined abscess: After per cutaneous drainage with IV antibiotics are performed, the patient can be discharged with the catheter in place. Interval appendectomy can be performed after the fistula is closed.

5)Adequate parenteral or IV nutrition needs to be given to prevent dehydration.

Thank you

Dr. John Monheit
Category: Family Physician-GP
Residecny: North Colorado Family Medicine
Medical School: The Chicago Medical Center
Dr. John Monheit and 4 other Medical Specialists are ready to help you

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