Appendcitic Flashcards
What age is appendicitis most common?
10-20years
How does an appendicitis occur?
Lymphoid hyperplasia or faecolith - obstructed the opening or the appendicitis - causing the nasty gut bacteria to invade the appendix walls- causing inflammation oedema and Ischemia
Where dose the pain radiate to in an appendicitis
Peri umbilical to RiF
This is due to localised parietal peritoneal inflammation
This is the strongest sign of appendicitis
When is the pain worst in appendicitis ?
When coughing and going over speed bumps
Note : kids cant hop on there right leg due to pain
What are the common signs of an appendicitis
Abdominal pain
One or 2 vomits
Diarrhoea (rare) - pelvic abscess
Mild fever - if the temp is higher think mesenteric adenitis
Anorexia - patients wont be hungry
Note: around 50% of patients have the typical symptoms of anorexia, peri-umbilical pain and nausea followed by more localised right lower quadrant pain
What do you find on examinations of appendicitis
Generalised peritonitis - perforation or local if there is no perforation
- rebound and percussion tenderness guarding and regity
DRE- boggy sensation - pelvic abscess
Rovsing’s sign =
palpation in the LIF causes pain in the RIF)
psoas sign =
pain on extending hip if retrocaecal appendix
psoas sign =
pain on extending hip if retrocaecal appendix
What test/ investigations are needed to make the diagnosis of appendicitis also what might the resulted be
Raised inflammatory markers + HX + exam = diagnosis
- lots of neutrophils in the WBC count
- urine - exclusion of pregnancy renal colic and UTI -
- US to look for free fluid and other pelvic pathology - more in females
What is the management of appendicitis
1:Appendicectomy open or closed
2: prophylactic intravenous antibiotics
