Appendicitis Flashcards
What is appendicitis?
Inflammation of appendix from obstruction where meets bowel, quickly proceesd to gangrene and rupture
Why is there a risk of peritonitis in appendicitis?
Rupture releases faecal content and infective material into the abdomen
How does pain present in appendicitis?
Central abdo pain that moves down to the Right iliac fossa and becomes localised there, Pain on McBurneys point on palpation
Where is McBurneys point?
Localised area one third distance form anterior superior iliac spine (ASIS) to umbilicus
Features of appendicitiis
Anorexia
N+V
Rosvings sign
Guarding on abdominal palpation
Rebound tenderness increased
Percussion tenderness
Sec abdominal pain RIF
What are the signs of peritonitis in appendicitis?
Rebound tenderness, percussion tenderness
What blood test suggests appendicitis?
Raised inflammatory markers
When is US used in diagnosis for appendicitis?
Female patients - exclude ovarian and gynae
What to do do if clinical presentation suggestive of appendicitis but investigations negative?
Diagnositc laproscopy - visualise appendix directly
Surgical treat appendicitis
Appendiecectomy
Differentials for appendicitis
Ectopic pregnancy
Ovarian cycsts
Meckels diverticulum
Mesenteric adenitis
Appendix mass
How to exclude pregnancy
Serum or urine bHCG
What can ovarian cysts cause?
Pelvic and iliac fossa pain, particuarly with rupture or torsion
When does Meckels diverticulum present similarly to appendicitis?
Bleed, inflamed, rupture or cause volvulus or intussusception
What is mesenteric adenitis?
Inflmaed abdo lymph nodes
What does mesenteric adenitis present with?
Tonsiliitis or URTI
Abdo pain
What is Meckel’s diverticulum?
Malformation of distal ileum. Usually asymtpomatic
How does an appendix mass occur?
Omentum surrounds and sticks to inflamed appendix forming mass in RIF
Conservative management + antibiotics, appendectomy
What are the complications of an appendicectomy
- Bleeding, infection, pain and scars
- Damage to bowel, bladder or other organs
- Removal of a normal appendix
- Anaesthetic risks
- Venous thromboembolism (deep vein thrombosis or pulmonary embolism)
