Appendicitis Flashcards
Early: periumbilical pain; later: right lower quadrant pain and tenderness.
Anorexia, nausea and vomiting, obstipation.
Tenderness or localized rigidity at McBurney point.
Low-grade fever and leukocytosis
Appendicitis
Vestigial organ
TRUE diverticulum of the cecum
Vermiform appendix
What are the possible locations of the appendix?
Preileal
Postileal
Pelvic
Retrocecal* abnormal presentation on PE
Retroileal* abnormal presentation on PE
Subcecal ** MOST COMMON
Appendicitis obstruction caused by? (5 things)
Inflammation
Fecalith
Calculi
Infection
Tumor
Appendicitis is a surgical emergency… early surgery w/ in?
36 hours
Classic clinical presentation?
Early vague colicky Periumbilical pain -> later migrates to RLQ
Pain becomes sharp and increased w/ peritoneal irritation (coughing, jumping, bumpy ride)
Pt will be lying still
Different locations cause different presentation. Pregnancy presentation?
Right flank pain
Right subcostal pain
(pain migrates up as baby enlarges in later trimesters moving the vermiform appendix superiorly and laterally)
Aside from the classic presentation, pts w/ appendicitis may also present w/?
Nausea/vomiting
ANOREXIA
Low grade fever
What are some PE findings of appendicitis
TTP at McBurney’s point (direct AND rebound tenderness)
Guarding/rigidity
Signs of peritoneal irritation include heal tap, Psoas sign, Rovsings sign, Obturato sign
Where is McBurney’s point?
2/3 of way from umbilicus to ASIS
Labs for appendicitis?
CBC (moderate leukocytosis)
CMP
UA
CT Sacn for IMaging BUT DON”T DELAY SURGERY IF NOT IMMEDAITELY AVAILABLE)
Tx for appendicitis?
**SURGERY (early/critical)
Abx may be given prior to surgery
What abx could we give prior to surgery for appendicitis?
Cefotixin
Ampicillin-Sulbactam
Ertapenem
