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The Rational Clinical Examination
David L. Simel, Drummond Rennie
Appendicitis, Adult
James M. Wagner, W. Paul McKinney, John L. Carpenter
Clinical Scenario


Topics Discussed: appendicitis, acute, rovsing's sign

Excerpt: "A 29-year-old patient presents to your office with abdominal pain and a fever. The patient was well until 1 day ago and had never experienced abdominal pain. A vague periumbilical pain awoke him from sleep 12 hours previously, and he soon developed anorexia, nausea, and vomiting. His wife consulted their family medical reference guide and then brought him to the office, concerned that his symptoms matched a description of appendicitis. The pain then migrated to the right lower quadrant (RLQ) and was much worse while he was riding in the car to the physician's office. ..."
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