Appendicitis

Question 0

Pre-op management of appendicitis

Answer 0

• Pt NPO
• Broad spectrum antibiotics (Augmentin)
• Crossmatch
• Obtain consent

Question 1

Ddx for RIF pain in females (excluding appendicitis)

Answer 1

• Salpingitis
• Ruptured ectopic pregnancy
• Pelvic inflammatory disease
• Diverticulitis

Question 2

Most common bacteria found in appendix

Answer 2

E.Coli

Question 3

Clinical Presentation

Answer 3

• Abdominal pain that localizes in RIF
• Anorexia
• Nausea & Vomiting
• Low grade fever

Question 4

Laboratory Findings

Answer 4

• Raised WCC
• Raised CRP
• Diff count: 75% neutrophils in 75% of cases

Question 5

Imaging studies

Answer 5

• CXR (erect)
• AXR (supine and erect)
• Abdo U/S
• Abdo CT

Question 6

Complications

Answer 6

• Perforation
• Pylephlebitis (inflammation of portal vein”
• Liver abscess
• Septic shock –> multi-organ failure

Question 7

Treatment

Answer 7

• Surgery (Appendicectomy)
• Antibiotics
• IV Fluids (correct electrolytes)
• Analgesia

Question 8

Complications of Appendicectomy

Answer 8

WRAP IF HOT:

• Wound infection
• Respiratory (atelectasis, pneumonia)
• Abscess (pelvic)
• Portal pyemia
• Ileus (paralytic)
• Fecal fistula
• Hernia (r. inguinal)
• Obstruction (intestinal due to adhesions)
• Thrombus (DVT)