Clinical Scenario
Mr. Smith is a 39 yo man with abdominal pain. He has been visited, few hours ago, by his primary care doctor who sent him to you for a surgeon consult. He refers abdominal pain, fever and nausea since the day before. The pain was previously in the midabdomen, than it migrated to the right lower quadrant (RLQ).
Temperature is 38°C, he is tachicardic, he has a moderate pain in RLQ, there aren’t signs of peritonitis. Appendix Is not visualized at US examination.
Laboratory evaluation reveals WBC count 12.000 (cells/microL) and CPR 7 (mg/L) .
Patient’s presentation is suggestive for appendicitis but not clearly diagnostic. Let’s see what the surgeon advices.
“He is not yet ready for the operating room” he says “it’s better to repeat a laboratory evaluation, please call me in four hours”.
The patient is admitted to observation unit.
How will the change of laboratory tests help you after four hours?