appendicitis

Question 1

definition

Answer 1

acute inflammation of the appendix

Question 2

appendicitis is the

Answer 2

most common surgical emergency of the abdomen

Question 3

most commonly caused by

Answer 3

a faecolith which obstructs the lyme of the appendix, the lumen of the appendix continues to secrete mucous which increases the pressure within the appendix and causes the physical compression of afferent visceral nerve fibres causing abdominal pain, the flora and bacteria become trapped in the lumen and are free to multiply which activates the immune system causing an increase in white blood cells, the append fills with pus and eventually can rupture due to the walls of the appendix infarcting

Question 4

symptoms of appendicitis

Answer 4

• abdominal pain, nausea, vomiting, fever
• pain classical begins in the umbilicus and migrates to the right iliac fossa
• pain over mcburneys point
• rebound tenderness
• rovings sign

Question 5

why does the pain in appendicitis migrate

Answer 5

pain begins in the umbilicus because appendix is a midgut organ and initially causes visceral pain but eventually as the appendix inflames it causes irritation of the peritoneum causing parietal pain localised to there right iliac fossa

Question 6

mcburneys point

Answer 6

one third of the way between the ASIS and the umbilicus

Question 7

rosvings sign

Answer 7

palpating the left lower quadrant illicit pain in the right low quadrant

Question 8

management

Answer 8

laparoscopic appendicectomy