Pediatrics - Acute Appendicitis
Caption
A 5-year-old patient with no relevant medical history was brought to the ED the previous day complaining of fever and mild abdominal pain. Due to a lack of specific clinical findings, he was treated with antipyretics and swabbed for COVID-19, which was negative. The following day, on its second visit to the ED, the child's fever persisted and had substantial abdominal pain that did not respond to first-line treatment, requiring subsequent use of ketamine. Physical examination was non-specific. POCUS of the RLQ immediately revealed acute appendicitis, as shown in this series of clips. Notice here on the left, the circular appendix in transverse view which is not deformed by compression with the probe; also can appreciate an abundance of peri-appendicular free fluid in the surroundings. Fanning the probe reveals an intraluminal fecalith with posterior acoustic shadowing. On the right is a longitudinal view also revealing an intraluminal fecalith. The patient was transferred to the regional referral hospital, and successfully underwent surgery which confirmed gangrenous appendicitis. Dr. Felipe Urriola P. Emergency Unit, Puerto Aysen Hospital. Chilean Patagonia.