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So after we’ve done the history and the physical and a blood test, if we’re still sort of going down this path where we think it might be an appendicitis, your next stop is going to be in radiology. You’re going to go to radiology to get a CT scan or cat scan of the belly. When you get the cat scan, usually it will be ordered with IV contrast and oral contrast. So you have to drink some stuff and you’ll have to get another injection through that IV of yours. And that helps the radiologist to see as much as we can possibly see and maximize our chance of diagnosing appendicitis. Well, on the CT, we first we identify the appendix, which like I said, it’ll be a little worm-like piece of bowel hanging off the colon. If it’s normal, then it’s pretty unremarkable looking, usually very small.
There’s usually gas inside of it. And then we can say normal appendix, and you’re pretty much done from the vantage of appendicitis. If you have appendicitis, like I said, a lot of times that appendix will be blocked by a stone and we might actually even see the stone that’s causing the blockage. The appendix though that’s infected and inflamed will be enlarged, will be engorged, filled with fluid. There will be inflammation all around it in the fat, inside your abdomen, that we can see on a CT scan too. So at that point we make the diagnosis and we say, this looks like appendicitis. We generate a report and we send it back to your doctor. Once the doctor has the report, and now they have a whole slew of evidence that you may have acute appendicitis. You’re going to have to see a surgeon. Now, the surgeon is basically like the appendicitis expert. So the surgeon will do their own history and physical exam, and they will ultimately decide whether or not they want to take you to the operating room to operate.
