Thanks. There could be various causes for the perforated bowel, and some patients just don’t do what the textbooks say - no fever, normal white blood cell count, or no free air on Xray, etc.
I’d bet she was seen by an ER doc on earlier visits; the triage nurse could delay the care, but not send her home without exam. (Unless things are much worse at that hospital than even the reports say.) So I’d be very curious to see the initial work up. It’s been known for years that a patient returning to the ER unexpectedly can mean an initially missed diagnosis. Three times would definitely make most docs look carefully. I agree, if she was diagnosed and treated promptly, she might be alive today.
I know abdominal pain is difficult to diagnose, but her condition should have sent up so many red flags to the ER staff. I work in the area of trauma so am not well versed on ER protocol when working up abdominal pain, but this all sounds so wrong. I can’t even begin to imagine our ER staff behaving this way and we have plenty of “frequent flyers”.
in a case close to me the initial fever was treated with a antibiotic, the fever spiked daily and returned to 98.6 a couple times a day, with NO pain, after a week the family doc did a CT and it was guessed that diverticulitis was the cause