Appendicitis and appendicectomy

Question 1

What is appendicitis?

Answer 1

Acute appendicitis is an acute inflammation of the vermiform appendix

Question 2

What causes appendicitis?

Answer 2

Most likely due to obstruction of the lumen of the appendix (by faecolith, normal stool, infective agents, or lymphoid hyperplasia)

Question 3

What are the signs and symptoms of appendicitis?

Answer 3

Abdo pain
Anorexia
RLQ tenderness
Nausea
Fever
Diminished bowel sounds
Tachycardia
Fetor
Rovsing's/ psoas/ obturator sign

Question 4

What are the RFs of appendicitis?

Answer 4

<6mths of breastfeeding
Low dietary fibre
Improved personal hygiene
Smoking

Question 5

What is the epidemiology of appendicitis?

Answer 5

Male (slightly more)
15-59
Low fibre diet countries

Question 6

What are the investigations that are appropriate for appendicitis?

Answer 6

Bloods- FBC (Mild leukocytosis)
CT abdo pelvis (wall thickening, inflammatory changes)
Urinary pregnancy test (negative)

Question 7

How do you manage appendicitis?

Answer 7

Appendectomy and supportive care (IV fluids, NBM)

IV antibiotics

Question 8

What are the complications of appendicitis?

Answer 8

Perforation
Generalised peritonitis
Appendicular mass
Appendicular abscess
Surgical wound infection

Question 9

What is the prognosis of appendicitis?

Answer 9

Good if treated quickly

Wound infection/ abscess which may decrease QoL

Question 10

What are the complications of an appendicectomy?

Answer 10

> High APACHE score may indicate high mortality

> Intra-abdominal Abscesses