Appendicitis

Question 1

Appendicitis is an inflamed appendix normally due to…

Answer 1

Lumen obstruction

Question 2

What is the peak age for appendicitis?

Answer 2

10-20

Question 3

True or false: appendicitis is a surgical emergency

Answer 3

True

Question 4

What are causes of appendicitis?

Answer 4

Faecolith (stony mass of compact faeces)

Lymphoid hyperplasia (Peyer’s patch = clusters of lymphoid follicles)

Filarial worms (parasite through mosquito bites)

Question 5

In appendicitis, the blockage is typically infected with ______ and as pressure increases inside the appendix, there is an increased risk of _____

Answer 5

E coli
rupture

Question 6

What condition can be a result of a rupture appendix?

Answer 6

Spontaneous Bacterial Peritonitis (SBP)

Question 7

What are symptoms of appendicitis?

Answer 7

Umbilical pain which localises to McBurney’s point
Rebound tenderness
Abdominal guarding
Pyrexia

Question 8

What are signs of appendicitis?

Answer 8

Rovsing’s sign:
Pain in RLQ when press on LLQ

Obturator sign:
Discomfort with slow internal movement of hip while right knee flexed

Psoas sign:
Painful to extend right leg when lying on left side

Question 9

A p____________ a______ is a complication of appendicitis

Answer 9

periappendiceal abscess

Question 10

How is appendicitis diagosed?

Answer 10

Gold standard = Abdominal and pelvic CT scan

Other tests:
Pregnancy test. Also rule out ectopic pregnancy which present with right iliac fossa pain

Ultrasound

FBC and CRP

Question 11

How is appendicitis treated?

Answer 11

Antibiotics with laparoscopic appendectomy

Must also drain abscess as any antibiotics won’t reach the walled off bacterial collection
Give intra-abscess antibiotics