Case 1 With around 250,000 appendectomies in the USA alone, the removal of the appendix is one of the most common operations of the gastrointestinal tract (Longo, Kasper, Jameson, Fauci, Hauser & Loscalzo, 2012). 66% of the patients describe periumbilical pain that migrates to the right lower quadrant afterward (Longo et al., 2012). Because of the peritoneal irritation that occurs during appendicitis, rebound or percussion tenderness and involuntary or voluntary guarding are present (Townsend, Beauchamp, Evers, & Mattox, 2017). Pain in the abdomen is provoked by any movement, so the patients usually refuse to move. Patients also take the fetal position in order to reduce intra-abdominal pressure and
Get 20% discount on your first order