The "speed bump" sign to detect appendicitis

This group in the UAE did a small prospective study suggesting that, among patients presenting with suspected appendicitis, the "speed bump sign" of increased pain over speed bumps is over 90% sensitive for appy.

Again, it's small. And the pretest probability in this group of patients was very high, while the specificity was low (40%). But, as with rebound tenderness, it's another reminder that peritonitis doesn't like to be jostled.

Oh, and hi--Low-Resource Medicine is back after an extended hiatus. We'll be posting relevant tidbits at intermittent intervals and always welcome readers' thoughts. Who knows; we might even update our look.

Delayed appendectomy

This article reviews a recent study published in the September Archives of Surgery that suggests it may be safe to delay an appendectomy in adults, even for over 12 hours.

We're not in the US, but we can offer decent supportive care here in rural Indonesia, and from what I can discern from the article, I think this study is good news for low-resource or remote practitioners. Fluids, antibiotics, one gives those, of course, but we probably have time to safely transfer a patient to a surgeon if he presents to our remote clinic with suspected appendicitis. That's nice to know.