{"id":1541,"date":"2020-04-28T07:21:17","date_gmt":"2020-04-28T07:21:17","guid":{"rendered":"http:\/\/emultrasound.sdsc.edu\/?p=1541"},"modified":"2020-12-23T20:06:45","modified_gmt":"2020-12-23T20:06:45","slug":"rlq-pain","status":"publish","type":"post","link":"https:\/\/emultrasound.ucsd.edu\/index.php\/2020\/04\/28\/rlq-pain\/","title":{"rendered":"Case # 20: Right Lower Quadrant Pain"},"content":{"rendered":"
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A 40 year old male presented with a 4 day history of right lower quadrant pain. He reported that the pain was at its worse when it started but gradually improved. When in the ED he noted only minimal discomfort without the help of analgesics.  He denied ever having anorexia, fever, chills, nausea, vomiting, GU complaints. During examination, he had moderate tenderness to palpation in the right lower quadrant without rebound or guarding.<\/span> <\/span><\/p>\n

Vitals:  T 97.7F    BP 130\/77    HR 66    RR 16   SP02 100%<\/p>\n

An abdominal ultrasound of the RLQ was performed and the following images were seen. What do you see and what is your most likely diagnosis? <\/p>\n<\/div>\n<\/div>\n<\/div>\n

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Answer and Learning Points<\/h3>
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Answer<\/strong><\/p>\n

In both the longitudinal and transverse views, you see a tubular structure in the right lower quadrant that is non- compressible, greater than 6mm (measures 15.6 mm), and lacks peristalsis. You can also appreciate some dependent free fluid around the appendix. These findings are consistent with the diagnosis of acute appendicitis. <\/span><\/p>\n

CT abdomen\/pelvis showed a retrocecal appendix with finding of acute uncomplicated appendicitis. No bowel obstruction or intra-abdominal\/pelvic abscesses. Labs showed a slight leukocytosis to 14, otherwise were reassuring. Patient was given a dose of Zosyn in the emergency department and take to the OR for appendectomy by general surgery. <\/span><\/p>\n

Learning Points<\/strong><\/p>\n