Appendicitis Flashcards
most common age for appendicitis?
2nd and 3rd decade
pathology of appendicitis?
obstruction of the appendices lumen
what causes obstruction of the appendical lumen?
lymphoid tissue hyperplasia, faeces, foreign bodies or worms
once lumen is obstructed, what happens ?
bacterial over growth
distension
ischaemia
inflammation
if left untreated, what can appendicitis lead to ?
necrosis, perforation, abcess, gangrene
which nerves localise pain to the centre of the abdomen?
splanchnic nerves
when does the pain become more localised
when the peroneum becomes involved
what kind of tenderness do you get at mcburneys point?
rebound tenderness (press at this point does not elicit pain, but relieve the pressure (the ‘rebound’) elicits pain (or elicits more pain than the initial pressing)
where is mcburneys point?
2/3 of the way between imaginary line between the umbilicus and ASIS
what is obturator sign>
pain felt on passive internal rotation of the hip
s/s of appendicitis ?
nausea, vomiting, anorexia, fever
why is delaying diagnosis of appendicitis left threatening?
increases risk of perforation and peritonitis
diagnosis of appendicitis ?
CT
USS
laparotomy (diagnostic)
what is the management ?
appendicectomy
when would appendicectomy be contra indicated?
IBD involving the caecum
