Appendicitis Flashcards
1
Q
What is appendicitis
A
Inflammation of the appendix
2
Q
How common is it
A
most common surgical emergency - 6% lifetime incidence
3
Q
What is the pathophysiology involved in it
A
- Sudden inflammation appendix –> usually caused by obstruction of lumen
- Gut organism invade wall –> inflamed + infected
- Rupture –> infected + faecal matter into peritoneal cavity –> peritonitis
4
Q
What are the symptoms in appendicitis
A
- Initially umbilical pain
- Then RIF pain (when peritoneum = inflamed)
- Anorexia, nausea, vomiting
- diarrhoea (sometimes)
- constipation
- Pain on coughing
- PR = pain on right
5
Q
What are the signs of appendicitis
A
- tachycardia
- Fever
- tenderness + guarding in RIF - migrating pain
- REBOUND TENDERNESS - McBURNEY’S POINT
- ROVSING’S SIGN - press LIF = more pain in right
- PSOAS test = flex hip against pressure
- OBTURATOR test = flex + internally rotate hip
6
Q
What are some differential Dx
A
- Cholecystitis
- Diverticulitis
- Crohn’s
- Perforated ulcers
- Food poisoning
- Ectopic pregnancy
- Cystitis
7
Q
What investigations would you perform
A
- Urinalysis - rule out UTI
- Pregnancy test - rule out ectopic preg
- FBC - mild leukocytosis
- Inflammatory markers ^^ (CRP)
- USS
8
Q
How do you treat appendicitis
A
- Surgery - appendectomy
- cefuroxime + metronidazole IV - pre-op –> prevent wound infection
