If used appropriately, activated charcoal has relatively low morbidity. Due to the lack of definitive studies showing a benefit in clinical outcome, it should not be used routinely in ingestions. AC could be considered for patients with an intact airway who present soon after ingestion of a toxic or life-threatening dose of an adsorbable toxin. The appropriate use of activated charcoal should be determined by the analysis of the relative risks and benefits of its use in each specific clinical scenario.
A 10-year-old boy presented with a 2.5-week history of right leg pain and limp. A right flank mass was noted by a parent on the day of presentation. The child's past medical history was remarkable for perforated appendicitis treated with an interval laparoscopic appendectomy 2 years before this presentation. Abdominal and pelvic computed tomography revealed a retroperitoneal mass with calcifications, suggestive of a retained appendicolith with abscess formation. This case illustrates the importance of considering very late complications of appendicitis in patients presenting with fever and abdominal or flank pain or masses.
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