missed appendicitis

Appendicitis classically presents as RLQ pain, fever, vomiting without diarrhea, a high WBC and normal UA. But pattern recognition is a great way to miss appendicitis–especially in children, women and the elderly–as the following studies makes clear.   CHILDREN The implications of missed opportunities to diagnose appendicitis in children. Acad Emerg Med 2013 Jun;20(6):592-6. In…

missed cerebellar infarction

Pitfalls in the Diagnosis of Cerebellar Infarction. Acad Emerg Med 2007;14:63-68. This retrospective review of 15 cases of misdiagnosed cerebellar infarction sheds light on a number of preventable errors. 28yo with headache, vertigo, nausea, fall to left, vision loss. Left sided weakness on exam but no documented gait. Normal CT/MRI. Diagnosed as migraine 38yo with…

approach to nausea/vomiting

Vomiting is sometimes assumed to be of GI origin, and dismissed as gastroenteritis if accompanied by loose stool. But vomiting it is a non-specific symptom that can arise from any body system and requires a thorough approach to diagnose and treat its cause and complications. Use the expanded ABCs to work through all body systems.…