appendicitis

Question 1

most commonly occurs in

Answer 1

2nd to third decade

Question 2

results from ?

Answer 2

obstruction of the appendical lumen

Question 3

what can obstruct the appendical lumen?

Answer 3

lymphoid tissue, faeces, foreign bodies, worms

Question 4

pain migration?

Answer 4

occurs due to the different innervations of the layers. The viscera (i.e. the appendix tissue itself) is innervated by the splanchnic nerves, which are poorly localising, and localise to the centre of the abdomen. Once the peritoneum becomes involved, different nerve pathways are activated, and the pain can be more closely localised.

Question 5

washboard rigidity?

Answer 5

peritonitis

Question 6

rebound tenderness at which point?

Answer 6

mcburneys

Question 7

where is mcburneys point?

Answer 7

2/3 way along imaginary line between umbilicus and ASIS

Question 8

what are bowel movements usually like in appendicitis ?

Answer 8

less frequent or absent

Question 9

which score is used for appendicitis ?

Answer 9

alvarado score (is a way of scoring suspected appendicitis clinically to identify those who may need surgery)

Question 10

when is appendicectomy contraindicated?

Answer 10

IBD involving the caecum

Question 11

investigations?

Answer 11

contrast CT, USS and laparotomy

Question 12

comps?

Answer 12

perforation +- peritonitis

abcess formation