Appendicitis and Diverticulitis Flashcards
What is the appendix?
It’s a diverticulum off the caecum
What is appendicitis?
Inflammation of the appendix
What typically causes appendicitis?
Usually due to an obstruction:
-lymphoid hyperplasia
-A fecalith (hardened piece of stool)
-Foreign bodies
How can a blockage in the appendix lead to tissue necrosis?
The blockage leads to increased pressure in appendix -> venous congestion -> oedema -> impairment of blood flow -> tissue necrosis
What can a ruptured or perforated appendix lead to?
Peritonitis
Contents of the appendix spill into the abdominal cavity, causing widespread infection and inflammation
What is the classic presentation of appendicitis?
Initial diffuse abdominal pain around umbilicus -> later localises to right iliac fossa
Why does the pain in appendicitis start poorly localised but then become well localised?
Starts poorly localised as it’s initially only the visceral peritoneum that’s irritated, its poorly innervated
When inflamed appendix comes into contact with parietal peritoneum (which has well defined nerve supply) pain becomes more localised and intense
How do we diagnose appendicitis?
-Clinical evaluation such as checking for rebound tenderness in the right lower quadrant
-Imaging - CT and ultrasound
How is appendicitis treated?
Surgical removal- Appendectomy
Can be done laparoscopically or as open surgery
Why is prompt diagnosis and treatment of appendicitis important?
To prevent serious complications such as perforation and peritonitis
What is diverticulosis?
The presence of small outpouchings (diverticula) in the colon, particularly the sigmoid colon
What can cause diverticula to develop?
Primarily do to increased pressure in colon caused by:
Low-fibre diet
Age-related weakness of colonic wall
How is diverticulosis discovered in a patient?
Typically asymptomatic.
Normally an incidental finding during diagnostic procedures such as colonoscopy or imaging scans.
What is diverticular disease?
The occurrence of abdominal pain and discomfort in individuals with diverticulosis.
Pain is usually mild, occurs without signs of inflammation or infection
What is acute diverticulitis?
It’s when one or more diverticula become inflamed or infected.
