Case Study 1

Anne is a 10 year old girl who has presented to the emergency department in the local hospital with right iliac fossa pain. On further assessment by the emergency registrar, appendicitis is suspected.
The surgical team agree that the signs and symptoms are associated with appendicitis and take Anne to theatre for an appendectomy.

The handover on return to the ward is that the surgical team found a gangrenous perforated appendix with peritonitis. Anne has returned to the ward with a nasogastric tube in situ on free drainage, morphine PCA, IV therapy and triple IV antibiotics.
Due to the severity of the infection and the potential complications, Anne will need to remain in hospital for 10 days of IV antibiotics and pain management.

Anne is the oldest of five children and her parents own and run an Indian restaurant in the city.

Case Study 2

Jay is a four-month old boy admitted to the paediatric unit via emergency with vomiting, decreased feeds, no bowel actions and intermittent spasmodic abdominal pains. During the spasmodic pain episodes, Jay draws his legs up and has a high pitched cry.
After a diagnostic ultrasound, intussusception was thought to be the cause of the presenting symptoms and Jay was admitted to the ward. His treatment plan included observation, electrolyte monitoring and IV therapy until a contrast enema could be implemented to correct the intussusception.

The approximate length of stay for Jay will be 2 days, during which time, Jay’s mother is informed that the rotavirus vaccine that Jay had at 4 months has increased the incidence of this condition amongst infants. Jay’s mother is now having serious doubts regarding future vaccines for Jay.