Ruptured Appendix Causes Internal Injuries, Infertility in Teenage Patient

Case Overview

This case involves a 15-year-old female who went to the local emergency room in Oregon with complaints of abdominal pain. Blood work was ordered which indicated a high white blood cell count. Radiology tests were not ordered and the patient was discharged with a misdiagnosis of the flu. The patient then went to her family physician the following day, where once again, a misdiagnosis of flu was made. Finally, several days later, the patient visited another doctor who identified a ruptured appendix. The patient was rushed to the hospital where an emergency appendectomy was finally performed. She suffered from numerous complications resulting from the ruptured appendix, including infertility, as a result of the delayed surgical intervention.

Questions to the General Surgery expert and their responses

How did a delay in diagnosis affect the surgical intervention, and did this delay alter this patient's outcome?

The delay in surgical intervention may very well have affected this patient's outcome. When it comes to acute appendicitis, prompt surgical intervention is always required to avoid permanent injury or death. Usually, an elevated white blood cell count, along with abdominal pain, should be immediately suspicious for appendicitis, and warranted closer investigation in this case. The fact that no additional testing was done after the elevated WBC was discovered would seem to indicate a breach in the standard of care.

About the expert

This accomplished expert earned his Bachelor's and medical degree from the University of California, Davis. He then pursued an internship and residency in General Surgery at the University of California, San Francisco. This expert is an active member of numerous professional societies, including America's Hernia Society and the Society of American Gastrointestinal and Endoscopic Surgeons. He currently serves as an assistant professor of surgery and the director of a comprehensive hernia center at one of the world's top academic medical centers.