Acute appendicitis and the acute abdomen

Question 1

Explain the pathophysiology of appendicitis

Answer 1

2/3 of cases
- Obstruction to lumen of appendix

1/3 of cases
- Inflammation in the mucus membrane or lymphoid tissue

Question 2

What are the different possible positions of the appendix and their prevelance?

Answer 2

Retrocaecal - 74%
Paracaecal - 2%
Subcaecal - 1.5%
Pelvic - 21%
Post ileal - .5%
Preileal - 1%

Question 3

What are the different clinical presentations of appendicitis

Answer 3

Acute uncomplicated appendicitis
Perforation with peritonitis
Perforation with abscess
Appendix phlegmon

Question 4

What are the signs and symptoms associated with appendicitis

Answer 4

Abdominal pain
Anorexia, nausea and vomiting
Localised tenderness and rebound
Low grade fever
Leukocytosis

Question 5

What are the investigations for appendicitis

Answer 5

Plain abdo xray
Infective markers
US
CT scan
Laparoscopy