Appendicitis

Question 1

Acute appendicitis occurs when..

Answer 1

The lumen of the appendix becomes obstructed by a hard discrete mass of thickened/congealed feaces

Question 2

epidemiology

Answer 2

affects all age groups

rare in very young and very old

Question 3

typical clinical symptoms

Answer 3

onset of central abdominal pain which then becomes localised to the RIF

accompanied by anorexia and sometimes V+D

Question 4

clinical signs

Answer 4

pt is pyrexial, with tenderness and guarding in the RIF due to localised peritonitis

may be a tender mass in the presence of an appendix abscess

Question 5

investigations

Answer 5

raised WCC, C-reactive protein and ESR (not specific)

ultrasonography: inflamed appendix ?appendix mass

CT is highly sensitive and specific

Question 6

management

Answer 6

surgical

open surgery or laparoscopically

conservative Tx for a mass: IV fluids and antibiotics

Question 7

complications

Answer 7

arise from gangrene and perforation –> localised abscess formation or generalised peritonitis