Appendix Disease Flashcards
What is the most imp part in diagnosis of acute appendicitis?
Physical exaimnation
What are the differential diagnosis for appendicitis in children?
MIAMI NUT
• Mesenteric adenitis(inflamed lymph node in the abdomen-Abdominal pain in children)
• Acute gastroenteritis
• Intussusception
• Meckel’s diverticulitis
• Inflammatory bowel disease
• Testicular torsion in men
• Nephrolithiasis
• Urinary tract infection
What are the differential diagnosis for appendicitis in elderly?
**Acute diverticulitis
-Gynecological problems
-Malignant diseases
-In neutropenic patients, typhlitis (neutropenic enterocolitis)
-malignant disease
Which sign is indicative of appendicitis?
-Mc Burney’s sign (Defense pain in right lower quad)
-Rovsing’s sign (Rebound pain when pressing on left lower quadrant then withdrawal pain is felt in RLQ)
-obturator sign
-psoas sign
What are the GIS symptoms in APpenedicitis?
Anorexia(pt who is hungry and asking for food doesn’t have appendicitis)
**nausea
Vomiting
What are the 3 abdominal palpation in appendicitis?
Rovsing’s sing
Obturator sign
Psoas sign
What are the lab findings in appendicitis?
• Leukocytosis (>10,000 cells/mm3)
• CRP (C-reactive protein)
• No symptoms, signs or laboratory results are distinctive for appendicitis.
What are the **findings of appendicitis?
-Nausea and vomiting(due to distention due to intraluminal pressure increase bcz of appendicitis obstruciton)
-rebound tenderness (Rovsing’s sign)
-pain in Mcburney’s
-Leukocytosis
What is imp to suspect in differential diagnosis of acute appendicitis in elderly?
Neoplasm/malignant disease
What is the most common tumor of the appendix?
Carcinoid tumor
What factor of the tumor is imp in carcinoid tumor of the appendix?
Tumor size
Patients with appendiceal adenocarcinoma are associated with ……. And ………
synchronous and metachronous neoplasms
[Malignancies that occur within 6 months of the first primary tumor are defined as synchronous while those that develop after the first 6-month interval are defined as metachronous ]
Which type of pain is present Mc Burney?
Defense
What are the direct percussion?
Mcburney’s sign
What is the indirect rebound pain in appendicitis?
Rovsing’s sing
The mucin filling of the peritoneal cavity in mucocele is called?
Pseudomyxoma peritonei**
What are the postoperative complication of appendectomy?
[Bleeding-infection-abscess-
stump appendicitis-Fistula]
• Surgical site infection (superficial/deep)
• Intraabdominal abscess
• Bleeding
• Gastrointestinal Fistula
• “Stump appendicitis” (Remaining stump should not be >0.5 cm)
In appendix carcinoid the malignant potential is related to?
Tumor size
Wht is the differential diagnosis of appendicitis in children?
MIAMI NUT
Mesenteric adenitis
Intussusception
Acute gastroenteritis
Meckel’s diverticulitis
Inflammatory bowel disease
Nephrolithiasis
Urinary tract infection
Testicular torsion
Etiology of appendicitis
**Fecal stasis
Neoplasm
Parasites (Askaris)
**Appendicitis Luminal obstruction–>pressure inc–>distention(–>nausea and vomiting)
Inc in gram negative or anaerobic bacteria
Know obturator and psoas sign
Benign tumor of mucocele is treated by:
Appendectomy
Malignant tumor of mucocele is treated by:
Left hemilectomy and ….
What is tx for mucocele
HIPEC(Hyperthermic (or Heated) Intraperitoneal Chemotherapy) done after surgery
………is not emergency is is when the omentum covers the ruptured appendix forming a tumor-like mass
Plastrone appendicitis
In adenocarcinoma, the tumor malignancy potential is dependent on..?
The depth of layer invasion
which dx tests are used to confirm appendicitis in a stable pt before surgery?
CT and U/S
