Appendicitis

Question 1

Cause

Substances like

Appendiceal fecaliths

Process

Perforation

Answer 1

obs of appendiceal lumen

feces, undigested food, enlarged lymphoid follicles

found in peopel w comp appendicitis

appendix dilates w inc pressure, bacteri invade ME- diminshed blood flow/necrosis/perforation

release bacteria/contents into peritoneum, leading to peritonitis of bowel loops/rectum

Question 2

Typical pop

complications more likely in

Answer 2

men, adolescents

kids

Question 3

CM

followed by

localized to

PE findings

refuse

Answer 3

Malaise, fever, anorexia, pain/cramping

high F, N/V/RLQ pain (parietal peritoneal inflamm)

McBurney point (1/3 between ASIS and umbilicus)

periumbilical tenderness
later, RLQ tenderness and guarding

movement (exacerbates)

Question 4

Appendix in young children

Occurs bc

Answer 4

more airable, diffuse ab tenderness, unwilling to ambulate

refuse movement (Psoas sign- passive hip flex or obturator sign- internal rot)

appendix is retrocecal/pelvic- contaacts iliopsoas/OI muscles

Question 5

Dx

Atypical presentation

CT ab/pelvis w contrast

Answer 5

surgical vis

imaging- US (enlagred, wall thickening, free fluid)

another option

Question 6

Mx

perforation

Beta lactam/BL inhib

Answer 6

Appendectomy

antibiotics+ surgery

piperacillin/tazo (cover anaerobes/gram -)

Question 7

Prognosis

CComp

Answer 7

inc risk w perforation

sx over 48 hrs (perforation)
Death from infection- ab/pelvic abscess/sepsis