Appendicitis* Flashcards
What is Appendicitis
Sudden inflammation of the Appendix due to lumen obstruction
Where does pain generally originate with appendicitis
McBurney’s point
1/3 from ASIS to Umbilicus
Where does the appendix come off from
Caecum
What is the Pathology behind appendicitis
Faecoliths/Lumphoid hyperplasia = obstruction
- Appendix obstruction
- Bacteria multiply and divide in appendix wall
- Pressure necrosis can occur leading to perforation
What are the causes of Appendicitis
Obstruction
Trauma
Faecoliths
Lymphoid hyperplasia
What are the symptoms of Appendicitis
Umbilicus pain moving to Right Iliac Fossa from McBurney's Rosving Sign (LLQ Press = RLQ Pain) N+V Anorexia Constipation Fever and tachycardia
What are the signs of Appendicitis
Right Iliac fossa pain
Rosving’s sign (LLQ press = RLQ pain)
Rigid peritoneum = perforation
Obtrurator and PSOAS pain
What are the bedside investigations of appendicitis
VBG - Check lactate
Urine HCG - exclude renal calculi
Urine dipstick - leukocytes
What are the lab investigations for appendicitis
Bloods -Raised WCC/ESR/CRP Renal function Clotting Blood cultures
What are the imaging investigations for Appendicitis
Ultrasound -Inflamed appendix -Appendical mass Chest XRAY -Exclude perforation CT(GOLD)
What is the Gold standard investigation for Appendicitis
CT
- High sensitivity
- High specificity
What is the management for appendicitis
Prophylactic antibiotics with fluids
Full Septic 6
Appendectomy
Drain any abscessed as Abs can’t enter
What is the septic 6 (give 3 take 3)
Give -Oxygen -IV Antibiotics -Fluids Take -Blood culture -Lactate measure -UO measure
What are some complications of Appendicitis
Perforation
Abscess (Needs drainage)
Gangrene
