About a month ago, 1st grader was in my office WRITHING in pain. He was in the panic phase where he looked like he was just going to bolt out the door because he didn't know how to process the pain he was in. Rebound tenderness. Rigidity. Guarding. No temp or vomiting though. Kiddo had been in just an hour earlier complaining of severe shoulder blade pain. When he returned, I thought "yep. It has to be his appendix and his shoulder pain he felt earlier must have been some referred pain." Told mom I was about 2 mins out from calling EMS when he ended up calming down and mom showed up and took him to the er. Ended up being impacted with stool. I knew he had a history of gut issues but the way he was presenting didn't say this was severe constipation. I was POSITIVE he was on the verge of a ruptured appendix.
So, I say all that to say, I think you did a great job with the info and the s/s you witnessed. I wouldn't have done anything different than you!
