EM Cases · Acute appendicitis
Perforated appendicitis — the septic RIF station
ACEM Fellowship resus/OSCE testing recognition of perforation, sepsis resuscitation, antibiotic doses and urgent surgical source control.
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Target exams
ACEMFRCEMABEMFRCPCCCFPEMEBEEM
Prompt
A young adult with delayed presentation of appendicitis who is septic with localised then spreading peritonitis.
Stem
All values, findings and observations in this station are fictional and invented for teaching assessment; they do not describe a real person.
Format. Clinical-management station, 11 minutes. You are the EM consultant.
Candidate instructions. Assess and manage. Examiner plays nurse/surgical registrar on the phone.
References4ShowHide
- [1]Alvarado A. A practical score for the early diagnosis of acute appendicitis. Annals of Emergency Medicine, 1986.PMID 3963537
- [2]Evans L, Rhodes A, Alhazzani W, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Intensive Care Medicine, 2021.PMID 34599691
- [5]CODA Collaborative, Flum DR, Davidson GH, Monsell SE, et al. A Randomized Trial Comparing Antibiotics with Appendectomy for Appendicitis. New England Journal of Medicine, 2020.PMID 33017106
- [7]Di Saverio S, Podda M, De Simone B, et al. Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines. World Journal of Emergency Surgery, 2020.PMID 32295644