2: Appendicitis Flashcards
What is appendicitis
Inflammation appendix
What age does appendicitis occur
10-30y
What is a risk factor for appendicitis
FH
Explain ethnicity for appendicitis
Appendicitis is most common in caucasians. However, in other ethnicities it is more likely to perforate
Explain symptoms of appendicitis
- Starts as peri-umbilical pain that radiates to LIF
- Associated nausea and vomiting
- Pyrexia
What are the 4 signs associated with appendicitis
- Mcburney’s
- Rosving’s
- Psoas
- Obturator
What is mcburney’s sign
Rebound tenderness - when pressing over McBurney’s point
What is roving’s sign
Pain in RIF when palpating LIF
What is psoas sign
Pain in LIF, when extending right hip
what does a positive psoas sign indicate
Retrocaecal appendicitis
why does psoas sign occur
Due to appendix irritating the PSOAS muscle
what is obturator sign
Due to appendix irritating obturator internus
if present, what does obturator sign indicate
retrocaecal appendix
what causes obturator sign
appendix irritating obturator internus
explain pathophysiology of appendicitis
inflammation of the appendix secondary to obstruction of the lumen
what causes obstruction of the appendices lumen in the following
a. young patients
b. patients 30-60
c. patients >60
a. hyperplasia of lymphoid tissue
b. faecolith
c. appendicular or caecal tumour
What blood tests are ordered for appendicitis
FBC
CRP
Explain imaging in appendicitis
Appendicitis is a clinical diagnosis. However, imaging may be used to support a diagnosis
What method of imaging is used for young children
AUS
Why is AUS used for children
- They have low body fat
- Avoid radiation
What method of imaging is used in older patients
CT
What scoring system is used to triage patients with appendicitis
Appendicitis Inflammatory Response (AIR) Scoring System
What is used to manage appendicitis
Pre-Operative Antibiotics
Laparoscopic appendicectomy
Why is the appendix sent for histology
Check for caecal or appendix tumour
What are 3 complications of appendicitis
- Perforation
- Appendix mass = omentum adhere to appendix
- Pelvic abscess
Describe blood supply to the appendix
Innervated by the appendicular artery a branch of the superior mesenteric artery
What is a differential diagnosis for appendicitis in younger children
Mesenteric adenitis
What is mesenteric adenitis
Inflammation of lymph nodes in mesentery
What does mesenteric adenitis usually follow
Viral infection
