Appendicitis Flashcards
signs and syx of appendicits 2
central abdo pain
-moves to the right iliac fossa over time and eventually becomes localised in the RIF
-on palpation there is tenderness in McBurneys point
anorexia
N+V
Rovsings sign (palpation of the left iliac fossa causes pain in the RIF)
guarding on abdo palpations
rebound tenderness- increased pain when quickly releasigng pressure on the RIF
percusssion tenderness when precussion the abdomen
define mcburneys point 1
loclaised area one third the distance from the anterior superior iliac spine (ASIS) to the umbilicus
what do rebound tenderness and percussion tenderness suggest
peritonitis-> caused by a ruptured appendix
diagnosis of appendicitis 3
based on clinical presentation and raised inflammatory markers
*-thin males may be diangosed clinically
CT scan
US scan in females to exclude ovariana and gynaecological pathology
if patient has clinical pressenation of appendicitis but investigations are negfative
perform diagnoistic laparoscopy to visualise appendix dirrectly
-surgeon can process to an appendicetomy during the same prodcedure if indicated
key differentials for appendicitis 5
ectopic pergnancy - serum or urine beta-HCG
ovarian cysts
meckels diverticulum
mesenteric adenitis
appendix mass
management of appendicitis 1
appendicectomy definitive managemnt
-laparoscopic surgery is preferred
-prophylatic IV ABx - reduces wound infection rates
*Older children, for example those aged above 10 years, can often be managed by adult general surgical teams at local hospitals, provided there is a paediatric department in the hospital. Younger children will need to be admitted under paediatric surgeons.
appendicits managment in perforation
perfoated appendicitis- copious abdominal lavage
complications of appendicetomy
bleeding, infection , pain , scars
damage to bowel,bladder and other organs
removal of a noraml appendix
anaesethic risks
