Acute Appendicitis Flashcards
How does AA occur?
Obstruction within the appendix resulting in the invasion of gut organisms into the appendix wall
What is the classic presentation of AA?
Periumbilical pain that moves to right iliac fossa
Where is McBurney’s point?
2/3 of the way along from the umbilicus to the right anterior superior iliac spine
What are some associated signs/symptoms?
Guarding, tender mass in RIF, pyrexia, anorexia, nausea and vomiting, Rovsing’s sign
What is the Rovsing’s sign?
Pain greater in RIF than LIF when the LIF is pressed
How might a retrocaecal/retroperitoneal appendix present differently?
Flank or RUQ pain
What might blood tests show?
Raised WCC, raised CRP and ESR
What imaging scans could you do?
US or CT
What are some differential diagnoses?
Crohn’s, UTI, diverticulitis, perforated ulcer, food poisoning, constipation
How would you treat AA?
Appendicectomy, IV antibiotics and fluid
What are some potential complications?
Perforation, adhesions, appendiceal abscess, appendix mass, pelvic inflammatory disease
Where shouldn’t you start palpations and why?
RIF as it makes it difficult to elicit pain elsewhere
What can cause obstruction in the appendix?
Faecoliths, foreign bodies, trauma, intestinal worms
What is the gold standard investigation?
CT scan
What tests would you do to exclude other causes?
Pregnancy test, urinalysis
