Acute Appendicitis

Question 1

What is appendicitis?

Answer 1

Appendicitis is when the appendix becomes inflamed. It can be acute or chronic. Accounts for more than 40,000 hospital admissions in England a year. More common in children 12-16 years.
Most common medical emergency of the abdomen.

Question 2

Appendicitis pathophysiology?

Answer 2

• Obstruction of lumen = build of gut wall secretions causing oedema= abdo pain
• Gut flora now trapped multiply = immune system activity and accumulation of pus in appendix = fever
• Pressure increase causes compression of blood vessels = ischaemia & necrosis
• Necrosis of tissue allows flora to invade gut wall, weakening the wall in the process
• Weakness of wall and pressure increase = rupture/perforation
• Rupture = peritonitis & rebound tenderness

Question 3

Appendicitis S&S

Answer 3

Periumbilical pain the moves to RIF.
-RIF Peritonism, guarding, tender on 
-Tachycardia
-Fever/nausea
-dry mouth, facial flushing, halitosis 
percussion, rebound
-Anorexia and loss of appetite
-Constipation & Diarrhoea
-Vomiting (rare)
-Pain worse when walking
-Coughing

Question 4

Suspected Appendicitis A&M

Answer 4

ABCDE
Is it life threatening?
-Consider likelihood of TC conditions such as AAA, Ectopic pregnancy, Sepsis, Testis torsion, traumatic disruption.

• If not life threatening:
• ABCDE
• Abdo examination, auscultation, palpation
• Full history
• If patient female consider gyno problems
• Consider O2 and fluids if necessary
• Transfer

Question 5

What is the appendix?

Answer 5

The appendix is a little one ended tube attached to the caecum of the large intestine. Sometimes called vermiform appendix.
Its function is unknown.