tag:blogger.com,1999:blog-4968787219619380438.post5203727087428936322..comments2023-09-21T04:02:29.457-04:00Comments on Skeptical Scalpel: Appendicitis: Diagnosis, CT Scans and RealitySkeptical Scalpelhttp://www.blogger.com/profile/13206922456661320751noreply@blogger.comBlogger306125tag:blogger.com,1999:blog-4968787219619380438.post-53294578583798749492020-07-12T12:37:20.998-04:002020-07-12T12:37:20.998-04:00I apologize for the delay in responding. I have no...I apologize for the delay in responding. I have not been monitoring my blog is closely as I formally did. I read your history and cannot see a pattern suggestive of any common illness.<br /><br />If three CT scans were negative for appendicitis, I think it's safe to say you probably don't have that disease.<br /><br />Have you had a gynecologic exam recently? Sometimes abdominal pain that cannot be diagnosed by routine methods turns out to be endometriosis. If you are still having problems, I suggest you see a gynecologist for a complete examination.<br /><br />I hope you're feeling better. Please let me know how things turn out.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-6446861903111337912020-06-23T18:03:22.431-04:002020-06-23T18:03:22.431-04:00Hi,
I know you have not had comments on this post ...Hi,<br />I know you have not had comments on this post for a while and I'm hoping all is well. I am a 25 yr old female that has had abdominal pain in the LRQ area and nausea with lack of appetite for around 3 months now. I have been to the ER 3 times over the past 3 months and am considering going for a fourth time but I don't want people to think I'm crazy. I've read your posts and understand you cannot provide medical advice online, this is almost just me venting because I'm so frustrated with how I'm feeling and it's exhausting not having any answers. During the past 3 months I have had 2 abdominal ultrasounds, 2 pelvic/intravaginal ultrasounds, 1 ultrasound trying to find my appendix (appendix couldn't be seen on ultrasound) and 3 CTs of abdomen and pelvis with contrast. All CT scans have indicated that a normal appendix is present and that there are no indications of acute appendicitis. The only thing that showed up in CT scan was an umbilical hernia, which I don't seem to see as I don't have a bulge. The only thing I can see is a black stone-like mass inside of my belly button (gross but just being honest). The ER doctor tried removing it during my 2nd visit but could not remove it. Regardless, I'm unsure if that would be causing my symptoms. All areas seen on the ultrasound appeared to be normal for my age and gender. Over the past 3 months I have not had fever, and basically require Zofran in order to feel like I can eat anything. I can't help but think this is appendicitis based on the location of the abdominal pain and the nausea that will not let up without anti-nausea medication (which I know is not good to be on long-term). I have been a little constipated but I've been that way my whole life, and getting loose stools after I drink the contrast for the CT scans that regulates after 48 hours. During my 1st and 2nd hospital visits (which were at the same hospital), I had elevated WBC and CRP levels (13,000/uL and 10,400/uL respectively for WBC and 12.5 mg/L and 12 mg/L, respectively for CRP levels). My WBC was fine during the 3rd visit (different hospital than the one I visited for my first and second visits) and was around 8,000/uL and they did not test CRP levels. My other bloodwork during all three ER visits seemed okay, some key takeaways were elevated calcium levels all 3 times (11.3 mg/dL, 10.7 mg/dL, 10.6 mg/dL). My anion gap and bilirubin levels were both higher than range for my first 2 ER visits but were in normal range for the 3rd ER visit. The ER nurse during my 2nd ER visit said that my eyes are jaundiced, which I never noticed but still seems to be true. My lipase levels were low all 3 times I was in the ER but they said that was not to be concerned about. I was diagnosed with a UTI as a result of the 3rd ER visit after there was blood and bacteria in my urine. After being on 3 types of antibiotics for the UTI, the abdominal pain and nausea have not gotten any better. It seems as if I'm in the ER every 4 weeks, but the pain worsens after my menstrual cycle and I almost feel at my best during my menstrual period. The pain is also rarely excruciating, it's really the nausea that is the worst part of it. The pain is more like a constant annoyance that sometimes does get pretty bad but the location in my mind just says appendicitis. It seems to feel low though and sometimes I feel the pain close to my right hip and extending into my back. I've lost almost 25 lbs as a result of how I'm feeling and it's honestly ruining my life. My family doesn't believe I'm in the pain and I'm terrified to tell them that I'm in the ER if another CT scan comes back clean. I just wanted to note that my first two ER visits were 2 days apart, as they said if I don't feel better to return. My 3rd ER visit was 8 weeks after my 1st/2nd ER visit. I'm seeing my primary dr in 2 days but I'm unsure if I will be able to make it there without another trip to the ER due to my symptoms. If you get to reading this, thank you in advance.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-17655233036356071722019-03-09T07:28:34.108-05:002019-03-09T07:28:34.108-05:00I am not sure what is going on. No real fever, nor...I am not sure what is going on. No real fever, normal white count, enlarged nodes make it look like a viral illness but it has lasted quite a long time. The CT scan showed inflammation of the terminal ileum described as "not acute" or in other words, chronic.<br /><br />I suggest you see a gastroenterologist who may want to investigate that terminal ileum with a colonoscopy or a capsule endoscopy. I wish I could be more helpful, but that's all I have at this point.<br /><br />Good luck and let me know how this turns out please.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-31409356448003434742019-03-08T18:14:23.147-05:002019-03-08T18:14:23.147-05:00Sorry for the long story I am about to write here,...Sorry for the long story I am about to write here, but I hope with the more information you have the better you can offer another opinion. I have read the disclaimers above, so I know this is not actual medical advice. I am 30-year-old Caucasian male, 5’9”, 182 lbs.<br /><br />1) I got gastroenteritis on Feb 14th, 2019. Severe nausea which later was followed by one instance of vomiting, diarrhea, chills, temp of 100. For the next few days, continued to have severe nausea with little to no appetite. Diarrhea lasted for another 24 hours. I know this was stomach flu because my 7-month-old son had it, my mother-in-law, my father-in-law, and my grandfather (all were in town for my son’s baptism).<br />2) Nausea continued so I saw my Primary Care P.A. on February 18th. I had been experiencing dull aches in lower abdomen, almost in the groin area. Best way I can describe the “pain” is the sensation of a pulled muscle and feeling swollen. She said I had lingering symptoms of gastroenteritis and told me to take probiotics to restore gut flora.<br />3) By February 20th, I was feeling normal, normal appetite, normal bowel movements for the most part.<br />4) February 24th, I woke up in the morning had coffee and about an hour later had severe nausea hit me out of nowhere. Almost had the urge to run to bathroom to throw up. I proceeded to go to urgent care. The PA there examined my abdomen and I had no pain or tenderness during examination.<br />5) Still had nausea following day, so I went to my primary care physician. My white blood cell count was up, temp was 99.1, and urinalysis detected some blood in my urine (not visible to naked eye). I was given another abdominal exam, again no sharp pain or tenderness, just the same swollen/ache pain in groin area. I began to have dull aches in my low back. I was put on 5 days of 500 mg of Cipro (2x day).<br />6) February 27th, I had a renal Ultrasound which also examined my appendix and pelvic area where I was having discomfort. All results came back normal.<br />7) During this week I was experiencing nausea mostly in the mornings which subsided by 11:00, although one night the nausea woke me up in the middle of the night for about 30 minutes.<br />8) By March 3rd, I felt mostly normal, ache in my pelvic area had subsided, nausea was mostly gone.<br />9) March 5th, nausea came back with a vengeance in the morning. I had my white blood cell count retested and it was normal (white blood cell 8.6, grans 69.6). Temp was 99.1. Again, abdominal examination revealed no tenderness or sharp pain. I was put on 500 mg of Cipro and 500 mg Flagyl (2xday) for 7 days. I was also scheduled for a abdominal CT scan with contrast and dye.<br />10) Today, Friday March 8th, received results from CT scan and all was normal except some inflammation of the terminal ileum that was not acute at the time of the scan. Feel better today, but nausea persists most mornings. No one can give me a diagnosis. Thought you might have some insight. Lymph nodes in underarms are tender so I assume I am definitely fighting some type of infection.<br />CJInscorehttps://www.blogger.com/profile/15417935538378681329noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-13194504009763737612019-02-27T09:27:14.585-05:002019-02-27T09:27:14.585-05:00Ultrasound is accurate in most studies but not so ...Ultrasound is accurate in most studies but not so much in real life.<br /><br />Chronic appendicitis was not too common in my experience. Cases I've seen usually presented as pain is similar to acute appendicitis and a history of previous attacks. CT scan showed inflammation and a dilated appendix in the right lower quadrant.<br /><br />It is amazing that with all the technology we have, appendicitis is still frequently missed. CT scan has helped, but misses still occur. I think nearly everyone with more than mild abdominal pain is getting a CT scan. Like I said in the post, I'd rather have the correct diagnosis than worry about the theoretical possibility of radiation-induced cancer in the future.<br /><br />Here's a link to a post my radiologist friend and I wrote about the unwarranted fear of radiation with CT scans:<br />http://skepticalscalpel.blogspot.com/2016/06/irrational-fear-of-ct-scans-in.htmlSkeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-35279411527002594392019-02-26T18:09:50.273-05:002019-02-26T18:09:50.273-05:00Thanks for the link to your summary of that paper....Thanks for the link to your summary of that paper. Seems interesting that ultrasound really isn't all that accurate resulting in a lot of false negatives. <br /><br />Another question for you: how often did you come across chronic appendicitis and how did it present to you and how did you finally diagnose it? I read through one poster's story and updates on here (the guy with the 11mm appendix) and that seemed like a case of chronic appendicitis. <br /><br />In your practice, did you ever come across anything that you thought was puzzling and not definite in terms of appendicitis, but you went the CT route anyways to find nothing remarkable only to have the same patient have a flare up later in time?<br /><br />Just as an anecdote, it's somewhat scary how often acute appendicitis is missed. Where I work, a patient who had classic symptoms of acute appy (along with fever, elevated WBC and CRP) was sent home because the ER doc thought it was more likely due to her kidneys and did not order any imaging. The patient returned a week later and was rushed into emergency surgery for a burst appendix and sepsis. <br /><br />A coworker of mine also had a sibling who was discharged from the ER with "cramps" and no imaging done only to have the pain worsen a few days later and the GP said to go back to the ER. CT confirmed appendicitis and rushed to surgery. <br /><br />I mean abdo pain is one of the most common complaints and appendicitis from what I understand doesn't always have a typical presentation. So based on the risks and costs, it doesn't make sense to CT everyone who could possibly have appendicitis but at the same time, it seems like a lot of cases are missed. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-6574671591077037482019-02-26T17:45:47.758-05:002019-02-26T17:45:47.758-05:00Re your first question. I guess that might be a wa...Re your first question. I guess that might be a way to use CRP provided research can be found showing there are no false negatives.<br /><br />I'm not sure about the accuracy of MRI vs. CT. In a study [https://www.ncbi.nlm.nih.gov/pubmed/30385123] about the contemporary diagnosis and results of appendicitis treatment, only 27 of 7778 patients had an MRI alone as their imaging. I would imagine its accuracy is close to that of CT.<br /><br />The paper is interesting. I blogged about it https://skepticalscalpel.blogspot.com/2018/11/appendectomy-outcomes-in-modern-era.htmlSkeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-49479772139746549492019-02-26T16:32:52.902-05:002019-02-26T16:32:52.902-05:00Thanks for your reply Skeptical Scalpel.
I guess...Thanks for your reply Skeptical Scalpel. <br /><br />I guess the CRP would be a screener to see if a appendicitis is a likely cause of some sort of vague pain and if negative, would not warrant a CT scan of the appendix? <br /><br />What about MRIs in terms of accuracy vs. CT scan? Mind you, I'm aware that MRIs have drawbacks such as access and the length of the scan which is a large factor in terms of getting an accurate image if the patient is in pain and can't remain still. That said, if a good diagnostic image is obtained from MRI, how does that compare to a CT in terms of accuracy? <br /><br />Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-15504952479507851592019-02-26T13:25:55.552-05:002019-02-26T13:25:55.552-05:00That is an excellent question. I have seen many pa...That is an excellent question. I have seen many patients with appendicitis who did not have fevers or elevated white counts. In my experience, it's about 10% of patients. I've been retired for a few years. When I stopped practicing, we were not ordering CRPs routinely. I can't comment on that.<br /><br />In keeping with the theme of this post, CT scan is very accurate. I don't know what a CRP would add to the accuracy of the diagnosis. Would you operate on a patient with no findings of appendicitis on CT but an elevated CRP? I wouldn't. Would you observe someone with a dilated appendix and a normal CRP? I wouldn't.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-80775387325182004112019-02-26T02:41:54.615-05:002019-02-26T02:41:54.615-05:00Dr. Skeptical Scalpel:
I know you said you won...Dr. Skeptical Scalpel:<br /><br />I know you said you won't be answering specific questions so I wanted to ask you a general one: in your practice, have you ever seen appendicitis (acute or chronic) if the pt is normothermic and has a normal WBC and a normal CRP? <br /><br />I work at a hospital as well and the few docs I've talked to seem to think that it's almost impossible to have any sort of appendicitis if the WBC AND CRP are normal. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-15413151253130469342018-12-13T10:02:10.356-05:002018-12-13T10:02:10.356-05:00Unknown, do you have any other symptoms besides mu...Unknown, do you have any other symptoms besides mucus in your stool? Have you lost any weight? Are there any other G.I. symptoms? Since your CT scan did not show any small bowel abnormalities, I’m not sure the small bowel camera study will be successful in locating the source of your pain, but it is relatively safe and simple to do.<br /><br />At some point you should definitely get a second opinion. I’m sorry I can’t be more helpful.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-79785867617652389992018-12-12T19:42:41.758-05:002018-12-12T19:42:41.758-05:00Hello I'm the 20 year old Male from the last p...Hello I'm the 20 year old Male from the last post. I just had my colonoscopy done & it came back perfectly normal he biopsied in 4 places just to see if something comes back. Still in pain in lower right side near belly button after fasting & cleansing for 2 days. He said the colposcopy would show in inflammation around the hole of appendix of if it was bad. So I'm at a loss, soon after I left I picked up a lot of paper work & all xray's, ultrasounds & ct scan on a disk and blood test. He said the only thing they could think is swallow a camera into my small intestines or get images from the outside of the oragns.Anonymoushttps://www.blogger.com/profile/02645407171327223583noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-54487577495919641762018-12-10T11:49:15.386-05:002018-12-10T11:49:15.386-05:00Unknown, the opening of the appendix can be seen d...Unknown, the opening of the appendix can be seen during a colonoscopy, but is not necessarily a good way to tell if it is inflamed. A CT scan is usually quite accurate in diagnosing appendicitis. If the colonoscopy does not find anything to explain your symptoms, I suggest you get another opinion. You would need to obtain copies of all your lab results, x-ray reports, and a disc with the imaging studies to take to your second opinion doctor. Let me know how this turns out please.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-54833250011626941472018-12-10T10:37:05.680-05:002018-12-10T10:37:05.680-05:00If the colonoscopy shows nothing like Crohn's ...If the colonoscopy shows nothing like Crohn's or colitis is it possible it could show the appendix? I am a 20 year old Male & My father & 4 of his brothers all had there appendix removed, Also is it possible I could get someone to re evaluate my ct scan. Cause clearly something isn't right Anonymoushttps://www.blogger.com/profile/02645407171327223583noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-85393349975543449862018-12-10T08:23:47.810-05:002018-12-10T08:23:47.810-05:00Unknown, I am sorry you are not feeling well. It a...Unknown, I am sorry you are not feeling well. It appears you have had a thorough workup so far. I can't think of anything that has not been done. I agree that a colonoscopy is indicated. I apologize for not being more helpful. I wish you all the best. Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-61787126809565467852018-12-10T03:57:21.478-05:002018-12-10T03:57:21.478-05:00Hi I am needing some medical advice. I have had pa...Hi I am needing some medical advice. I have had pain & pressure like something is going to blow or a brick sitting on my right side by belly button for the past month or two. I have been to the doctors office and Er over 10 times. I had a ultrasound on my gallbladder & kidneys came back normal. I then was in the er had a ct scan with contast & had the highlight drink. They said the scan was normal. I cannot sleep at night with the pain. I can't sleep on right side or lay flat in back without pressure & pain in right lower side across from belly button. Have temp of 100 for months but bloodwork shows normal CBC & Cmp & urian test. I recently had a gdc scoop showed I had little reflux & they dialated my throat & some inflamed stomach. I am now going in for a colonoscopy this upcoming Wednesday. I have not vomited or nothing but I have lots of mucus in stool. I feel that the hospital I had the ct scan was a joke the name is Baptist hospital. I also have a strong heart beat in the spot & it don't get better with bowel movements or eating habits. It's just a pain & pressure in one area no where else on right side across from belly button.Anonymoushttps://www.blogger.com/profile/02645407171327223583noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-17326006947977733882018-09-07T17:11:51.552-04:002018-09-07T17:11:51.552-04:00I had no idea. Thanks for the information.I had no idea. Thanks for the information.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-13236495333662967002018-09-06T23:35:30.965-04:002018-09-06T23:35:30.965-04:00Appendicitis is a painful medical condition in whi...Appendicitis is a painful medical condition in which the appendix becomes inflamed and filled with pus, a fluid made up of dead cells and inflammatory tissue that often results from an infection. Appendicitis is one of the leading causes of sudden severe abdominal pain requiring surgery in the United States, according to the National Institutes of Health (NIH). You can also refer to this article which states all the necessary details about appendicitis https://www.everydayhealth.com/appendicitis/guide/Anonymoushttps://www.blogger.com/profile/09331428154410865504noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-20159166663400519672018-06-14T13:19:26.956-04:002018-06-14T13:19:26.956-04:00I am sorry for the delay in posting your comments....I am sorry for the delay in posting your comments. I did not realize Blogger is no longer sending me emails notifying me of comments awaiting approval.<br /><br />I hope you are feeling better. To give or not give oral contrast for a CT scan done to investigate appendicitis is the subject of much debate. It seems to be a matter of institution or radiologist preference. Oral contrast adds little to the accuracy of the scan and delays doing the scan by hours. This is because patients take a while to drink it, and it doesn't do any good unless some time elapses so the contrast can reach the right colon.<br /><br />When the appendix is not seen on a CT scan it is normal nearly every time. This is particularly true if there are no signs of inflammation in the right lower abdomen.<br /><br />If you are still having pain, you should keep the G.I. appointment.<br /><br />I'm sorry I cannot be more helpful, but a lot of information is missing such as your age, whether your pain is associated with any other symptoms such as nausea, vomiting, diarrhea, or constipation although you did mention that the scan showed you had some stool in your colon which is not unusual. Other findings of importance would be whether the pain prevents you from sleeping or wakes you up from sleep where the pain is worse with activity.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-21958820801856937532018-06-06T14:10:40.009-04:002018-06-06T14:10:40.009-04:00Hi, I'm not asking for medical advice. I'm...Hi, I'm not asking for medical advice. I'm looking for help interpreting a report. Last month, I started having increasing lower-right abdominal pain. After two weeks of this (and a week of Cipro for a suspected UTI), my doctor told me to go in for an ultrasound to see if they could locate my appendix. They didn't find my appendix, so I was sent to the ED for a CT. I was told the CT was normal, was given referrals to GYN and gastroenterology (which have taken forever to get into--that's especially frustrating since my gastroenterology appointment ended up being canceled and rescheduled weeks later), and was sent home. I recently got the report back, and I'm a little confused.<br /><br />It says "Evaluation of the bowel loops is limited due to lack of oral contrast. No bowel obstruction. Small bowel loops are unremarkable. Normal appendix is not identified. However, there are no inflammatory changes in the right lower quadrant to suggest appendicitis. There are a increased number of small right lower quadrant lymph nodes, non-specific."<br /><br />When I had come back from the CT, the ED doc said she was surprised they didn't give me oral contrast. They only gave me IV contrast. Is this normal? I understand from the other comments that not finding an appendix on the CT usually means it's not appendicitis. But I'm confused as to why they didn't administer oral contrast or say anything to me about the clarity of that part of the scan. There is a note saying I may be constipated, but I just hadn't gone yet that day.<br /><br />It's probably just me obsessing over it, which is easy to do when there are no answers in sight. All my subsequent test results (blood, urine, GYN ultrasound, and the rest of that CT) have been normal -- right now I'm waiting on the GI appointment and whatever tests they decide on. But I'm really not sure what it means when they say that "evaluation...is limited." To me, that points to the possibility of missing something (like appendicitis), but is it just a general comment?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-385738832611747692017-11-11T08:47:55.104-05:002017-11-11T08:47:55.104-05:00Anon, thank you so much for the follow-up which I ...Anon, thank you so much for the follow-up which I rarely get here. I'm glad you are doing well. Yes, the "large wall defect" was where it burst.<br /><br />It was bold of your surgeon to not remove an 11 mm appendix in 2014. I would have taken it out and suspect most surgeons would have. Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-13600581658102392742017-11-11T08:16:12.677-05:002017-11-11T08:16:12.677-05:00Not sure if this space is still being monitored. ...Not sure if this space is still being monitored. Skeptical Scalpel has been spectacular with respect to answering questions and providing support over the years. I simply wanted to update my experience; the last post/response I provided was on Feb 4, 2014.<br /><br />I presented with limited to zero symptoms, yet a CAT scan with a 11mm distended appendix. Further details are listed in the prior 02-04-2014 post. About two years later, I felt pain in the same LRQ, but felt short term comfort about what it was. Hoping it would subside, waited almost 24 hours as the pain became worse. Eventually went to large teaching hospital that knew my history. They assumed upon presentation that my appendix was stressed. Found that appendix had burst, curled upon itself. Secondary peritonitis, green infected fluids, comments about intro-abdominal sepsis. Eventually a 104 degree fever, but was in a good spot at the hospital to address that. The terms they used were: acute suppurative appendicitis, periappendicitis, transmural perforation, mesoappendiceal abcess, secondary peritonitis (generalized and localized), adbominal sepsis. The appendix they eventually removed was 14mm, with a large wall defect (guessing that was the bursting). The surgeon said it was interesting to deal with challenging situations. So we all had some fun. But I slowly recovered over the following weeks, months - and have felt comfortable and confident over the months/years since...Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-74067775534257934072017-11-01T09:06:52.768-04:002017-11-01T09:06:52.768-04:00As I mentioned in my disclaimer at the beginning o...As I mentioned in my disclaimer at the beginning of this post, I cannot give you medical advice because I have not taken your history, examined you, or seen your lab and x-ray results myself.<br /><br />The other thing about a CT scan is that it may show an ovarian cyst or some other abnormality that is causing your pain. <br /><br />If your symptoms are worse, you should be seen by a doctor again.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-73385149712021755182017-11-01T08:59:09.300-04:002017-11-01T08:59:09.300-04:00The test showed that the appendix was normal.The test showed that the appendix was normal.Olivianoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-58928923374732031882017-11-01T08:54:03.320-04:002017-11-01T08:54:03.320-04:00Olivia, when you say nothing showed on the tests, ...Olivia, when you say nothing showed on the tests, does that mean the appendix was seen but was normal or the appendix was not seen at all? There's a big difference. Even if it was seen on ultrasound, the test may not be accurate.<br /><br />If your symptoms are progressing, you might need a CT scan which is more accurate than an ultrasound.<br /><br />Your history sounds a lot like appendicitis, but it could be other illnesses.<br /><br />I suggest you see your pediatrician or return to the emergency department as soon as possible. Please let me know how this turns out, and good luck.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.com