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Is it his appendix, doctor? Part 2 (Teacher: Michael)

Next, there is rather sudden bout of vomiting. This usually rouses whole household and often family doctor. By time he is called sufferer may begin to feel bit hot. He looks more than just in pain; he looks ill.

This is most usual course illness takes. wretched appendix (which doesn't even seem to serve any useful function) although fixed to lower bowel at one end, can lie pointing in any direction of compass. And this fact can change symptoms considerably.

If it is pointing upwards it can give rise to suspicion of pneumonia. If pointing outwards, that is towards loin, it can cause fears that pain may be due to kidney. If it points directly downwards diarrhoea may be early symptom and infection of bowel has to be considered.

These facts make diagnosis difficult for doctor in minority of cases, but for parents any abdominal pain in child is worry. What has gone before is often important - what doctor calls history of case. Has child been to party and eaten too much ice-cream or too many sour apples? Has he had sore throat day before and got virus infection? If pain is slight does he refuse any offer of food?

An American surgeon, when in doubt, used to ask child if he would like hot, roast pork sandwich. If he said 'yes', surgeon would wait before operating. It needs healthy child with good. appetite for this test to work.

Remember that in acute appendicitis pain does not get gradually better. If during attack child starts to want to play or asks for food, diagnosis is almost certainly not that of acute appendix. Be suspicious of youngster whose pains begin on consecutive Monday mornings just before school!

If in doubt, if pain persists or worsens, or if patient begins to look or feel hot, don't delay. Remember that operation done in good time is remarkably safe and youngster is quickly full of beans again.

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