Appendicitis Flashcards
Peak occurrence of appendicitis (age?)
In patients 10-20 years old
Where is Mcberney’s point?
1/3 of the distance from the ASIS to the umbilicus.
What are the classical features of appendicitis?
Central abdominal pain that moves down to the RIF Anorexia N+V Low grade fever Rosvig's sign Guarding on palpation Rebound tenderness Percussion tenderness
What is Rosvig’s sign?
Palpation on the left side of the abdomen causes tenderness on the right.
How do you diagnose appendicitis?
Clinical presentation and raised inflammatory markers.
CT scan can be useful to diagnose when another diagnosis is more likely.
USS is used in females to exclude gynaecological pathology.
USS can be useful in children when a CT scan is less appropriate.
What do you do when the diagnosis is unclear?
a period of observation - watch and wait.
Diagnostic laparoscopy with appendectomy if indicated
What scoring system can be used to calculate the probability of appendicitis?
Alvarado score
What is mesenteric adenitis?
Inflamed abdominal lymph nodes
What is mesenteric adenitis associated with?
Tonsillitis or an upper respiratory tract infection
What is the treatment for mesenteric adenitis?
No treatment
Conservative management only, will self resolve
When do you get an appendix mass?
When the omentum becomes adhered to the inflamed appendix.
Managed with antibiotics and supportive treatment with an appendicectomy carried out once resolved.
