Appendicitis Flashcards
Basic anatomy of the appendix
The appendix is a narrow blind-ended tube that is attached to the posteromedial end of the cecum (large intestine
Location of the appendix
Located at McBurney’s point which lies 2/3rds of the way from the u billicus to the ASIS
What is acute appendicitis
Sudden inflammation of the vermiform appendix
Most common reason for appendicitis
Obstruction of the appendix
What does obstruction of the appendix lead to …
1-Invasion of the gut organism into the appendix wall
2- leads to inflammation , necrosis and eventually perforation
What can cause obstruction of the appendix
FACEOLITHS
bezoars/ foreign bodies
Trauma
Intestinal worms
Lymphoid hyperplasia
Most common clinical presentation of appendicitis
Early pain / discomfort around the umbillicus that migrates to the right iliac fossa in the first 24hrs and eventually becomes localised in the RIF
Clinical presentation of acute appendicitis
Guarding
Pyrexia
Anorexia
Nausea
Tender mass in rif
differential diagnoses of acute appendicitis 5
Acute Crohn’s disease
Ectopic pregnancy
UTI
diverticulitis
Perforated ulcer
Gold standard investigation for AA
CT- highly sensitive and specific
What other investigations would you do for AA
Blood tests - raised wcc due to inflammatory response and raised Crp
US- can detect an inflamed appendix
Pregnancy test to exclude
Urinalysis to exclude UTi
Management for acute appendicitis
Gold standard - appendicectomy
Iv antibiotics and fluids
Complications of acute appendicitis
Perforation
Appendix mass
Appendiceal abscess
Adhesions
PID
How would you differentiate appendicitis from ectopic pregnancy
A serum or urine hCG test to exclude pregnancy
What is an appendix mass
Occurs when the omentum surrounds and sticks to the inflamed appendix forming a mass in the right iliac fossa
