Appendicitis

Question 1

Presentation of appendicitis

Answer 1

• Peak incidence 10-20 years
• Abdominal pain - typically central then settling in RIF
• Anorexia, nausea and vomiting
• Tender to McBurney’s point (1/3 from ASIS to umbilicus)
• Rebound tenderness and percussion tenderness indicate peritonitis
• Rosving’s sign (palpation of LIF causes pain in the RIF)

Question 2

Diagnosis and management of appendicitis

Answer 2

• Diagnosis
  
  • Clinical based on signs and raised inflammatory markers
  • CT can help confirm diagnosis
  • US to exclude ovarian and gynecological pathology
• Management
  
  • Conservative with supportive treatment and antibiotics
  • Appendicectomy once acute condition resolved