Appendicitis Flashcards
1
Q
Peak incidence of appendicits at…?
A
10-12yo
2
Q
What is the classical presentation of appendicitis?
A
- Abdominal pain lasting more than 4 hours
- Periumbilical pain shifting to RIF
- Diarrhoea
- Anorexia
- Lying still
- Pallor
- Foetor
- Low-grade fever
- Guarding
- Other signs of peritonism
3
Q
What are some atypical presentations of appendicitis?
A
- Retrocaecal appendicitis
- Vague non-localizing RIF pain with deep RIF tenderness – often without guarding
- Pelvic appendicitis
- Lower abdominal pain and tenderness
- Urinary symptoms
- Small volume diarrhoea
- Perforated appendicitis
- Presents with generalised peritonitis
- Risk of perforation greater in young children
- Communication difficult
- Less omental localization
4
Q
What is retrocaecal appendicitis often mistaken for?
A
mesenteric adenitis = self-limiting inflammation of mesenteric lymph nodes in RLQ
5
Q
What is pelvic appendicitis often mistaken for?
A
Gastroenteritis
6
Q
What is perforated appendicitis often mistaken for?
A
Viral illness
7
Q
What Ix might you do for appendicitis?
A
- FBE looking for neutrophilia
- Plain AXR
- Abdominal U/S: thickened, non-compressible appendix with increased blood flow
- No routine role for CT
8
Q
What are some common DDx for appendicitis?
A
- Gastroenteritis
- Mesenteric adenitis
- UTI
- RLL pneumonia
- Testicular torsion
- Strangulated inguinal hernia
9
Q
Complications of appendicitis
A
- Appendix mass
- Abscess
- Perforation
10
Q
What must you do before appendicectomy?
A
• ***Correct dehydration and electrolyte disturbance before surgery (replace half of fluid deficit before theatre)
