Appendicitis Flashcards
What are the advantages of laproscopic appendix removal?
Can see more in the abdominal cavity
What is a typical presentation of appendicitis?
Periumbilical pain that moves to McBurney’s point
N/V
Loss of appetite
Diarrhoea
Low grade fever (max 38.5)
Tachycardia
Urinary symptom (+/- leukocyte + on dipstick)
When do you US in ?appendicitis?
In women where the story could be ovarian pathology
Why does Rovsing sign occur?
Stretching of the peritonium on the left side irritates the inflamed peritonium on the righit side localising the peronitis
How do you know you’re at the base of the appendix?
It’s the convergent point of the taenia coli
What are the most common position of the appendix?
- Retrocaecal
- Pelvic
- Retroileal
Where are the ports in a laproscopic appendisectomy?
Infraumbilical
LIF
Suprapelvic
(5mm each)
How can a retroileal appendix appendicitis present?
Periumbilical pain predominating
How can a pelvic appendix appendicitis present?
Pain with walking
Diarrhoea (due to irritation of the rectal wall)
What do you think of in a patient with a appendicitis story and high fever?
Perforated appendix
Viral infection - mesenteric adenitis
When do you CT in a ?appendicitis?
?Cancer in a >50 years
?Renal colic (eg a lot of blood in urine)
?Crohn’s - longer history
In which patients do you further Ix for a cause of appendicitis? What do you do?
>50 years old
Abdo CT
Why does appendicitis occur?
Obstruction of the appendix outlet
- faecolith (stone of faeces)
- lymphoid hyperplasia (in young people)
- Cancer of the caecum
- Worms
