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Flashcards in Appendicitis Deck (6)
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What is appendicitis.

Inflammation of the vermiform appendix (arises from the caecum).


What is the incidence of appendicitis.

Lifetime incidence = 7%.
It is rare in the very old and very young. (rare in very young because the appendix is cone shaped with a larger lumen)
It is most common in those aged 10-20.


What causes appendicitis.

It is due to a bacterial infection secondary to luminal obstruction (most often a faecalith or lymphoid hyperplasia)
This then leads to oedema, ischaemic necrosis and perforation.


What are the symptoms of appendicitis. (7)

Furred tongue.
Pain on coughing.
Foetor and/or flushing.
Shallow breathing.
Classically a colicky central abdominal pain (inflammation of the appendix) followed by a localisation of pain to the RIF (inflammation of overlying peritoneum).
Nausea, vomiting and constipation/diarrhoea are variable.


What are the signs of appendicitis. (6)

Low grade pyrexia.
Patient tries to minimize movements.
RIF tenderness.
Guarding and rebound/percussion tenderness.
Right sided tenderness on PR.
Rovsing's sign: RIF pain on palpation of LIF.


What is the differential diagnosis for appendicitis. (6)

Ectopic pregnancy.
Ovarian torsion.
Diverticulitis (although pain is more common in LIF)
Pelvic inflammatory disease.
Crohn's disease.
Mesenteric adenitis.