http://www.appliedradiology.com RSS Feed on Applied Radiologyhttp://www.appliedradiology.com//Issues/2012/11/Cases/Stump-appendicitis.aspx<p>A 65-year old woman presented to the emergency department with abdominal pain that began earlier the same day. She complained of nausea and loss of appetite. The patient had been recently diagnosed with osseous metastatic lung cancer. Medications included only acetaminophen/oxycodone for pain management. Her surgical history was significant for a laparoscopic appendectomy with pathology-proven appendicitis performed approximately 29 months prior to this visit.</p> <p>On admission, the patient’s physical examination revealed severe generalized abdominal tenderness with more focal epigastric tenderness and guarding without rebound. Routine laboratory studies revealed a leukocytosis (white blood cell count = 17.7 cells/ microliter) with an increased percentage of neutrophils (15%). Differential diagnosis included gastroenteritis, inflammatory bowel disease, pancreatitis, peptic ulcer and biliary disease. The emergency physician was concerned about the patient’s abdominal pain and ordered a computed tomography (CT) scan of the abdomen and pelvis following the administration of intravenous and oral contrast agents. </p>Wednesday, 07 Nov 2012 15:52:17 GMT