Discover and read the best of Twitter Threads about #appendicitis

Most recents (4)

Do you know all of these nuances of #pleuraldisease? Why is an #empyema distinct from a complicated #parapneumoniceffusion? What is #contarinisyndrome #explosivepleuritis #chyliform #pseudochylous? Are all #chylothorax milky? #pccm #pulmcrit #pulmonary
#pleuraldisease is fascinating and nuanced. First step is #lightscriteria which give favor to finding #exudates which tend to be more urgent. You only need one criterion, which maximizes #sensitivity. Meaningless statement: "It's an exudate only by protein." One criterion=exudate
(Like on Tinder, the more criteria you require, the more you narrow your pool, compromising sensitivity for specificity.) Transudates I will skip over. Most common #exudate is #parapneumoniceffusion #PPE. If there is or is likely to be #pneumonia, it's PPE. Next task is to...
Read 26 tweets
Weekend Digest

Name the Pathogen

5 Clues:

- #Chitlins
- #Iron sepsis
- Mesenteric #adenitis
- Reactive #arthritis
- Terminal #ileitis Image
2/
#Yersinia enterocolitica

It is #zoonotic and is acquired by exposure to contaminated food.

When #IDBR says #chitlins (#chitterlings), you say Y. enterocolitica

Chitlins are food made of pork intestines (where Y enterocolitica resides)

ncbi.nlm.nih.gov/pmc/articles/P…
3/
#Yersinia enterocolitica

Enterobacteriaceae #GNB that causes #enterocolitis, diarrhea (often bloody), terminal #ileitis, mesenteric #adenitis, and RLQ pain that may be mistaken as #appendicitis (#pseudoappendicitis)
Read 6 tweets
Let's take a little break from #COVID19 and talk #appendicitis were I breakdown the @EMBoardBombs ULTIMATE appendicitis guide with the legendary Dr. Mary Claire O'Brien. Hat tip @blakebriggsMD @IltifatMD emboardbombs.com/podcasts
emboardbombs.com/papers/2019/8/…
Inflammation of the vermiform appendix is one of the MCC causes of acute abdomen worldwide.

It occurs most commonly in ages 10-30. In children <5, its incidence is <5%.

Forget what you learned in med school. This condition can be very difficult to diagnose w/out imaging
It results from an initial inflammation (due to obstruction from fecalith, calculi, lymphoid hyperplasia, infection, tumors) -> Increase in intraluminal pressure along with bacterial overgrowth —> necrosis and perforation
Read 25 tweets
Very proud of our recent paper on #epi of #appendicitis just published in @JAMASurgery | ja.ma/2wHn6p2 | Thankful to my collaborators @ReeceGeo, @SESanchezMD, & @DaveFlum | Thankful to @BMCSurgery & the Tauber Fam Foundation who gave me time to work on it. Thread 1/11
Most (not all, of course) papers written on appendicitis in last 10-20 yrs have been based on proportions: # cases w perforation / # cases of appendicitis [including several studies by yours truly!]. But this metric requires a big assumption … 2/11
The assumption is that the groups of patients who are being compared (say, patients with private insurance vs. patients with Medicaid vs. patients with no insurance) all come from populations at equal risk of #appendicitis. But does this assumption hold up? 3/11
Read 12 tweets

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