Appendicitis Flashcards
What is appendicitis?
Inflammation of the appendix
What is the appendix?
A blind-ended vermiform tube attached to the caecum
What does vermiform mean?
Worm shaped
What does the appendix do?
Nothing
Which people most often get appendicitis?
Between age 10 and 20
Describe the pathogenesis of appendicitis?
Lumen of the appendix is obstructed by faecolith
Gut organisms invade the appendix wall
This leads to oedema, ischaemia, necrosis, and perforation
What are the clinical features of appendicitis?
Central abdominal pain that localises to the right iliac fossa
Anorexia
Vomiting + diarrhoea or constipation
Pyrexia
Tenderness + guarding in RIF
Tachycardia
Shallow breaths
Coughing causes pain
Where does pain localise in appendicitis?
Right iliac fossa!
Investigations of appendicitis?
Bloods:
- raised white cells
- raised CRP + ESR
CT will show it up
BUT often there’s no time to delay, if unsure err on the safe side and go for appendectomy
Treatment of appendicitis?
Prompt appendectomy
Antibiotics: metronidazole + cefuroxime
Differential diagnosis of appendicitis?
Ectopic pregnancy UTI Cystitis Cholecystitis Diverticulitis Crohn's Perforated ulcer Infection
What are the complications of appendicitis?
Perforation leading to peritonitis
Appendix mass
Appendix abscess
