appendicitis Flashcards
pathophysiology
pathogen trapped due to obstruction at point where appendix meets bowel
leads to infection and inflammation which can proceed to gangrene and rupture
rupture releases faecal contents and infective material into peritoneal cavity –> peritonitis
presentation
abdo pain: starts centrally then moves to RIF tender McBurney;s loss appetite N+V fever rovsing's sign gaurding rebound tenderness
McBurney’s point
one third distance from ASIS to umbiliccus
key differential diagnoses
ectopic pregnancy
ovarian cyst
meckel’s diverticulum
mesenteric adenitis
abdo pain : F childbearing age
assume pregnant until proven otherwise with pregnancy test
serum HCG usually part of normal abdo pain blood panel inA&E
appendix mass
occurs when omentum surrounds and sticks to inflammed appendix, forming RIF mass
manage conservatively with supportive treatment + antibiotics
appendicetomy once acute condition has resolved
Mx
appendicectomy
complications of appendicectomy
bleeding, infection, pain, scars damage to bladder, bowel removal normal apendix anaethetic risks VTE