Appendicitis Flashcards
What is the Appendix?
Worm like appendage attached to the fist part of the colon located in the right lower quadrant
What is Appendicitis?
Inflammation of the appendix most likely due to obstruction of the lumen of the appendix
In which age group is Appendicitis most prevalent?
10- 20 years
=> Unlike to occur in children < 2 due to the large lumen
What re the risk factors of Appendicitis?
- Age (10-20)
- Gender (male)
- Family History
What is the differential diagnosis of Appendicitis?
- Ectopic Pregnancy
- UTIs
- Cholecystitis
- Dysmenorrhoea
- Crohn’s Disease
- Perforated ulcer
- Food poisoning
- Diverticulitis
What are the causes of Appendicitis?
- Faecolith (hard stools)
- Normal stools
- Lymphoid hyperplasia
What are the clinical features of Appendicitis?
- Anorexia
- Vomiting
- Peri-umbilical pain radiating to Right Iliac fossa (strongest indicator of appendicitis)
- Constipation
- Periods of diarrhoea
- Pain during PR exam
Patients try to lie as still as possible
What are the special signs elicited in Appendicitis?
=> Rovsings Sign - pressing down on LIF causes pain in RIF
=> Psoas Sign - pain of hip extension
=> Cope Sign - pain on flexion and internal rotation of hip
=> Pressing down on McBurney’s point causes pain
What is McBurney’s point?
On the line joining the umbilicus to the ASIS, it is 2 thirds of the way from the umbilicus
What are the investigations in suspected Appendicitis?
=> Bloods
Raised inflammatory markers
=> Urinalysis
Mild leukocytosis with no nitrites
=> Pregnancy test
To exclude possible pregnancy cause
=> Abdominal CT (1st line)
What is the management of Appendicitis?
- Open or laproscopic appendicectomy
- IV prophylactic antibiotics
What are the common complications of Appendicitis?
- Perforation
- Appendix mass
- Appendix abscess
