Diagnosing Appendicitis - My Experience and How I Do it

[@noraclark7677]

You are an amazing teacher. This was set up so well with the short videos you have put out in the last few days and then presented so clearly! I was able to understand almost all of it. Your students are incredibly lucky!

[@citizensurgeon]

Hope you enjoy this video on how to work up appendicitis! Next will be how we treat it!

[@trudgingtheroadofhappydest3983]

🇨🇦. Hi. Not related to this video but a question. How does liquid get from the mouth to the bladder so fast? If moisture is sucked out in the large colon? But that would take at least a day. I’m sure there’s a simple explanation but I can’t see it. Please help. A patient not a medical person.

[@citizensurgeon]

Remember that the gi tract and the urinary tract are separate…the gi tract absorbs enteral fluid…that fluid makes it to the blood stream and is filtered by the nephron within the kidney which…based on hormones like ADH or aldosterone and the loop of Henle with its concentration gradient will either make more or less urine.

[@trudgingtheroadofhappydest3983]

@@citizensurgeon 🇨🇦. Wow thank you so much for replying. Your answer made it sound like the liquid from the mouth has to go through the colon to the blood to the kidneys, filtered and then to the bladder. Which is what I thought but you also mentioned a separate system for the urine? My example is I drink coffee next thing I know I have to pee. How does it get there so fast? Judy. PS. I want to understand. It’s just a mystery and I can find an answer anywhere. I know you are very busy so if you could even direct me to something to read that would be fantastic. Thanks again. I really enjoy your content.

[@citizensurgeon]

It is very interesting isn't it? Caffeine is a diuretic and so after you have a couple of cups your kidneys are going to start making more urine. Here's a comment from a Mayo Clinic article... As a chemical, caffeine increases production of urine, which means caffeine is a diuretic. But most research suggests that the fluid in caffeinated drinks balances the diuretic effect of typical caffeine levels. High doses of caffeine taken all at once may increase the amount of urine the body makes. This is more likely if you aren't used to caffeine. www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/caffeinated-drinks/faq-20057965#:~:text=As%20a%20chemical%2C%20caffeine%20increases,of%20urine%20the%20body%20makes.

[@noraclark7677]

Interesting to hear you say that appendicitis always progresses! What about patients that have recurring episodes of pain before it develops to the acute stage? For instance, I remember very clearly having attacks of pain over a period of time. They left an impression on me. I recall being curled up in a chair with pain, and being sent home from school because of it, and times when the family doctor came to the house and examined me and thought it might be appendicitis but all the symptoms were not enough to be convincing. And then it would settle down and I would be fine for a while. When it finally became acute and they took it out, I never had abdominal pain again so my appendix must have been responsible all along. Was I unusual?

[@citizensurgeon]

In my experience patients with an obstructing fecalith causing appendicitis will have that story, intermittent pain for months due to waxing and waning dilation of the appendix, then finally, one day it causes total obstruction which leads to appendicitis and it has to come out.

[@citizensurgeon]

Great observation!

[@noraclark7677]

@@citizensurgeon Thank you for this information. In my case the diagnosis must have been more difficult than it would be now as doctors didn’t have all the tools they have now. I am quite sure ultrasound was not available and they definitely did not have ct scans or mri. There have been so many awesome advances!

[@zaidwanifitness8305]

Can a presentation get any better?

[@citizensurgeon]

Thanks so much! What do you want to learn next?

[@OlisaPrice-qq1wm]

😎 video about Apendetis

[@citizensurgeon]

Thanks!!

[@yuiyui3331]

This is good subject, saw many kids die from this. Caused of late dx. This would help more kids❤ I like how to you try to teach with lots of details.. Details​ that you will get only from experience​ from many years of work. Great jobs! Keep doing! ❤ Do you have link to research for CT increase risk of cancer. If you have, could i have a link plz. Thx u❤

[@andresmyers494]

Wonderful video, the clarity of your explanation is awesome. Greetings from Mexico City.

[@benjaminazumah9833]

Thanks Doc.

[@citizensurgeon]

You are welcome!

[@Gmoneygrip1960]

Dude your hella smart!

[@citizensurgeon]

Haha! Thank you!