Appendicitis and Diverticular Disease Flashcards
What is the etiology of appendicitis?
Caused by obstruction of appendiceal lumen by fecalith which leads to inflammation and infection. Ages 10-30 year old.
What are the clinical manifestations of appendicitis?
- Initial: intermittent periumbilical pain
- 12 hr later: pain RLQ (McBurney’s point), constant worse with movement.
- Nausea and vomiting, low-grade fever, decreased appetite
What physical exam finding would you expect to see in a patient with appendicitis?
- Guarding RLQ, cutaneous hypersensitivity
- Positive Rovsing’s sign
- Positive Psoas/Obturator sign with peritonitis
What labs would you order for a patient with appendicitis and what would you expect the results to be?
Increased WBC with left shift
X-ray, Ultrasound, CT scan
What is the treatment for appendicitis?
Appendectomy
What are the types of Diverticular disease?
- Diverticulosis: presence of diverticula
- Diverticulitis: inflammation of diverticula
What is the etiology of diverticular disease?
Increased intraluminal pressure
What are the signs and symptoms of diverticular disease?
Diverticulosis: crampy LLQ pain, rectal bleeding, 80% no symptoms
Diverticulitis: Acute LLQ pain, anorexia, fever, chills, nausea/vomiting, positive peritoneal signs
What physical exam findings would you expect to see in a patient with diverticular disease?
Diverticulosis: firm, tender mass LLQ
Diverticulitis: decreased bowel sounds, distention, rebound tenderness, fever, acute abdomen
What lab result would you expect to see in a patient with diverticular disease?
Diverticulosis: normal labs
Diverticulitis: Increased WBC with left shift
What radiographic characteristics point to diverticular disease?
- X-ray: Air-fluid levels
- BE: lesions, appendages
- CT scan: abscess, perforations
What is the treatment for diverticular disease?
Diverticulosis: Decreased intraluminal pressure with high fiber diet
Diverticulitis: Antibiotics, Liquid diet, Surgery
