Appendicitis Flashcards
Define appendicitis
Inflammation of the appendix
Aetiology of appendicitis
2
Gut organisms invade appendix wall after lumen obstruction
Leads to oedema, ischaemic necrosis & perforation
Epidemiology of appendicitis
general, age
MOST COMMON surgical emergency
Most common 10-20 yrs old, but can occur at any age
Presenting symptoms of appendicitis
5
Periumbilical pain that moves to the RIF Anorexia Vomiting (may occur after pain) Constipation Diarrhoea
Signs of appendicitis on physical examination - general
7
Tachycardia Fever Furred tongue Lying still Coughing hurts Foetor w/without flushing Shallow breaths
Signs of appendicitis on physical examination - RIF signs
3
Guarding
Rebound & percussion tenderness
PR pain on right side
Signs of appendicitis on physical examination - special signs
(3)
Rovsing’s sign - palpation in the LIF causes more pain in RIF than left
Psoas sign - pain on extending hip
Cope sign - pain on flexion & internal rotation of hip
Signs of appendicitis on physical examination - variation in clinical picture
(general, child, elderly)
Inflammation of retrocaecal/retroperitoneal appendix may cause flank pain or RUQ pain
only sign maybe tenderness on right on DRE
Child may have vague abdo pain & not want to eat fav food
Shocked confused 80+ yr old not in any pain
Investigations & findings for appendicitis
2,1,1
Bloods
High WCC (mainly neutrophils)
High CRP
Ultrasound
CT
High diagnostic accuracy
Management of appendicitis
2
Prompt appendicectomy (laparoscopy) Antibiotics - cefuroxime, metronidazole
Complications of appendicitis
3
Perforation
Appendix mass
Appendix abscess
Prognosis of appendicitis
uncomplicated & ruptured
Uncomplicated appendicitis - most recover w/ no long term problems
Ruptures appendix - greater risk of complications/death
