tHarmston (2011) stated that the appendix could
cause irritation of the rectum, which might lead
to alteration of bowel habit, usually diarrhoea.
Timothy had not eaten for 48 hours. He did
not have any medical history, had not taken
medication at the time pain commenced and
stated that he was not allergic, as far as he was
aware, to any drugs or foods. Medical history
should establish the presence or absence of
cardiac illness, diabetes, Crohn’s disease, peptic
ulceration and any past surgery. In addition,
alcohol consumption and smoking status should
be recorded because these factors may contribute
to abdominal disorders such as pancreatitis,
splenomegaly, hepatitis and gastroduodenal
ulcers (Stewart and Ackroyd 2011). The patient’s
travel history should be explored because
particular diseases, for example hepatitis,
cholera and parasitic infections, are endemic
to some overseas locations (Mahadevan 2005).
It is also useful to ascertain the patient’s family
history. It was established that Timothy’s mother
had hypertension.