Appendicitis has been in the news a bit recently. That's not normal! So, I’m taking this unusual opportunity to share some insights—unique ones, I dare say—about this condition which I diagnose frequently as an ER doctor.
First, Late Night host Stephen Colbert was hospitalized and had an emergency operation to remove his ruptured appendix. Appendicitis occurs when the small worm-like appendage coming off the base of the colon gets inflamed and infected (for reasons that aren’t clear, most of the time). Ruptures happen when the pressure gets to be so great from a build up of pus, that the dang thing bursts.
Then, there was a story about the condition on NPR, which described a simple test worried parents can try on their kids. Basically, if you’re concerned your kid has appendicitis, asking them to jump as high as they can has some diagnostic utility; if they don’t double over in excruciating pain, it’s less likely appendicitis. The inverse (i.e., jumping causes pain) moves the needle towards the diagnosis. But I’m not sure how useful the test really is. Even the study NPR cited studied the “jump up test” as one component of a suite of tests that included a bunch of blood work, and the information in either direction is not sufficient to rule the condition in or out.
Here’s the fun part.
Recently, I diagnosed a patient with appendicitis on sight. As in—I could swear I diagnosed the condition before I had even spoken to the guy, let alone had the chance to physically examine him. Then—get this—I did it again on another patient a couple of weeks later.
Let me explain why I think my predictions were neither random, nor a sign that I’m actually some kind of psychic, clairvoyant, appendicitis whisperer…
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