Appendicitis is one of the most common reasons people undergo abdominal surgery. Lost in history are the reasons why appendectomy was performed in the first place, and in the hundred years since appendicitis was first described, many changes in patient management have occurred improving both the diagnosis and treatments for appendicits. A major trial, Antibiotic Therapy vs Appendectomy for Treatment of Uncomplicated Acute Appendicitis, was recently published in JAMA showing that most patients with acute, uncomplicated appendicitis can be treated with antibiotics alone and avoid surgery.
Minor head trauma usually does not cause significant brain injury. To be safe, clinicians often obtain head CT scans to ensure no major injury is present. For minor head trauma (Glascow coma scale 13-15), the risk to benefit ratio for head CT is usually not in favor of getting CT scans. When the Canadian head CT rule or New Orleans Criteria are negative, there is a very small risk for missing a significant brain injury. Joshua Easter, MD from the Department of Emergency Medicine at the University of Virginia who authored a JAMA Rational Clinical Examination article on this topic is interviewed as is Frederick Rivara, from the Department of Pediatrics at the University of Washington who wrote an accompanying editorial. Michelle Mello, a Law Professor at Stanford, discusses the medical liability associated with not obtaining neuroimaging for minor head trauma.