Appendicitis Flashcards

1
Q

What is the appendix?

A

small, thin tube of bowel sprouting from the caecum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What causes appendicitis?

A

Results from obstruction of the appendix and subsequent infection and inflammation of the appendix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Peak incidence

A

ages 10-20

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Symptoms

A
  • Abdominal pain, typically central then settling in the right iliac fossa (RIF)
  • Loss of appetite (anorexia), nausea and vomiting.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Signs

A
  • Tender to McBurney’s point (1/3 the distance from the ASIS to umbilicus)
  • Guarding to RIF
  • Rebound tenderness (increased pain when releasing deep palpation to the RIF) and percussion tenderness indicate peritonitis
  • Rovsing’s sign (palpation of the left iliac fossa (LIF) causes pain in the RIF)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Diagnosing

A
  • Diagnosis is mostly clinical based on signs and raised inflammatory markers
  • CT can be useful in confirming diagnosis in confirming the diagnosis, particularly where other diagnosis more likely
  • USS can be useful in women to exclude ovarian and gynae pathology
  • If clinically appendicitis but tests are negative may proceed to diagnostic laparoscopy – appendicectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Differentials

A

•Ectopic pregnancy (in women of childbearing age) ◦Gynecological emergency with relatively high mortality if mismanaged
◦Essential to get a serum bHCG to exclude pregnancy / ectopic

•Ovarian cysts (with torsion or rupture)

•Meckel’s diverticulitis ◦Malformation of the distal ileum in 2% of the population
◦Can become inflamed and infected in the same way as the appendix

•Mesenteric Adenitis (usually in younger patients) ◦Abdominal pain caused by inflamed abdominal lymph nodes
◦Often associated with cough/cold
◦No treatment required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is an appendix mass?

A
  • Signs of appendicitis with palpable mass in RIF
  • When the omentum and / or bowel surround and stick to the inflamed appendix
  • Typically managed conservatively with supportive treatment and antibiotics, with appendicectomy once acute condition has resolved
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do you treat appendicitis?

A
  • Definitive management for acute appendicitis

* Laparoscopic is associated with fewer risks and faster recovery versus open

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Complications of appendectomy?

A
◦Bleeding / infection / pain / scars
◦Damage to bowel, bladder or other organs
◦Removal of normal appendix
◦Anaesthetic risk
◦DVT / PE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly