Appendicitis (vermiform appendix) Flashcards
What is the post common anatomical position for the appendix?
75% is retrocaecal (behind the caecum) - so often appendicitis doesn’t have many clinical signs.
What is the main cause of appendicitis?
Trapped faeces
can also be swollen lymph nodes
What are the clinical signs of appendicitis?
Peri umbilical pain that transfers to right iliac fossa within 24hrs Painful mcburneys point Rebound tenderness Nausea Vomiting GI upset (constipation more common than diarrhoea) fever Loss of apetite Rovsings sign Guarding Percussion tenderness Tachycardia
What is rovsings sign?
When palpation of the left iliac fossa causes pain to be felt in the right iliac fossa
What are clinical signs of peritonitis?
Percussion tenderness
Rebound tenderness
Where is myburneys point?
1/3rd of the distance between anterior superior iliac spine to the umbilical cord. (On the RIGHT)
How is appendicitis diagnosed?
Mostly on clinical signs
Imaging - US or CT (only done if unsure about diagnosis)
Erect Chest X ray (excludes perforation)
Blood test - High WBC count
HCG (in all child bearing aged females)
Urine - positive leukocytes
Diagnostic laparoscopy (+appendectomy at the same time)
What are the differential diagnosis of appendicitis?
Ectopic pregnancy
Ovarian cyst
Mesenteric adenitis (swollen lymph nodes)
Renal calculi
What causes an appendix mass?
When the mesentery wraps around the appendix
Treated conservatively then appendectomy is done
What is the treatment for appendicitis?
Prophylactic antibiotics
Appendectomy - mostly laparoscopically
What are the complications of an appendectomy?
Bleeding Infection Pain Scars Damage to bowel, bladder or other organs VTE Gangrene Local abscess Perforation Removal of healthy abscess
Which age is appendicitis most common in?
Between 10-20
Not common in the young or >50
