Thursday, April 23, 2009

Oopsy-daisies



A surgeon in Minnesota removes a sliver of tissue on a patient, thinking it was the appendix. It wasn't. The pathologist informed the operating surgeon that it was just a chunk of fat. So he brought her back to the hospital and removed what, by then, had become a perforated appendix. I hate when that happens.

I can understand how it could have occured. Advanced appendicitis can cause an intense inflammatory reaction, obscuring the normal anatomy. But you have to be extra-vigilant in these cases. Make a bigger incision if you need to. Be sure of the anatomy; follow the tenia coli of the cecum to their coalescence. For God's sake, open the specimen on the back table if you're uncertain. Ultimately, it seems that this particular patient recovered and resumed a normal life. But it just doesn't look good to have to treat appendicitis on the second try; we like elegance and precision when we operate....

6 comments:

OHN said...

Yowza. I am not surprised that the surgeon no longer works there.

I AM surprised that the patient went back to the same hospital, and to the same surgeon though...I would think they would do a double-take on that information and go to someone else for the "real" procedure. :)

Frank Drackman said...

Colleage of mine in the Navy did the same thing with vasectomies...kept wondering why the sperm count came back in the millions...He doesn't do Vasectomies any more...

He's a Cardiac Surgeon
Not in the Navy

The Happy Hospitalist said...

If this patient had died, would it be considered malpractice? Or would it be considered a complication of the disease process?

Buckeye Surgeon said...

Malpractice? If the patient had died from sepsis due to delayed treatment of appendicitis, I think there's probably a case...

Frank Drackman said...

C'mon Buckeye,
Have YOU ever left a hot Appy inside one of your patients???

This is Mal-practice with a capitol Mal...

Guy should have just said he was doing an "Appendix Sparing Appendectomy"...

Frank

Kellie said...

About 2 years ago I did an appendectomy on someone who had reportedly had their appendix out 50 years ago. Still had an appendix and he did get appendicitis. He was furious, as you might imagine.

BTW, he had a huge incision from his appendectomy 50 years ago.