Appendicitis - Porth, Chpt. 29

Question 1

Appendicitis

Acute Appendicitis

Answer 1

• Extremely common
  
  • Frequently in 20- to 30- year old age group
    
    • but can happen to ANYONE

Question 2

Appendicitis

What happens to the Appendix?

Answer 2

• Inflamed
• Swollen
• Gangrenous
  
  • If not treated…
    
    • PERFORATES

Question 3

Appendicitis

Cause?

Answer 3

• Unknown
  
  • possibly Related to Intraluminal Obstruction w/ a Fecalith or to twisting

Question 4

Appendicitis

Onset

Answer 4

• Abrupt
  
  • Pain referred to Epigastric or Periumbilical area

Question 5

Appendicitis

What’s going on?

Answer 5

• Caused by stretching of appendix during early inflammatory process
  
  • Pain & Nausea
  • Initially vague.. then 2-12 hours later
    
    • BAM - increases w/ colick
• It localizes when:
  
  • Inflammatory process extends & involves serosal layer of appendix

Question 6

Appendicitis

Findings

Answer 6

• Elevation in Temperature
• WBC count >10,000mm³
  
  • ^​w/ 75%+ polymorphonuclear cells

Question 7

Appendicitis

Findings - PE

Answer 7

• Palpation of abdomen =’s
  
  • Deep Tenderness in the LRQ
  • Ask person to point to the area of pain
    
    • They usually point RIGHT TO IT!
• Rebound tenderness & Spasm of overlying abdominal muscles = common

Question 8

Appendicitis

Diagnostics

Answer 8

• Hx and PE
• Ultrasonography or CT = confirm diagnosis
  
  • CT = gold standard

Question 9

Appendicitis

Treatment

Answer 9

• Surgical Removal of Appendix

Question 10

Appendicitis

Complications

Answer 10

• Peritonitis
• Localized periappendiceal abscesses
• Septicemia