Appendicitis

Question 1

What is the definition of appendicitis?

Answer 1

Inflammation of the appendix

Question 2

What is the lifetime incidence of appendicitis?

Answer 2

The lifetime incidence of appendicitis is 6%

Question 3

What is the pathology of appendicitis?

Answer 3

• Appendix normally becomes obstructed/infected with faecal matter
• Can just be generalised inflammation

Question 4

What are the risk factors/aetiology of appendicitis?

Answer 4

• CF
• Infection
• Obstruction/injury to the bowel
• Inflammatory bowel disease
• Low fibre diet
• UC - protective

Question 5

What are the signs/symptoms of appendicitis?

Answer 5

• Initially central abdominal pain – radiated to right iliac fossa, coughing or walking makes pain worse
• Nausea/vomiting
• Anorexia
• Diarrhoea
• Pyrexia
• Appendix mass – surgery may not be needed

Question 6

What diseases present similarly to appendicitis?

Answer 6

• Non specific mesenteric lymphadenitis
• Acute terminal ileitis – due to Crohns disease
• Inflamed Meckel’s diverticulum
• Functional bowel disease
• IBS
• Gastroenteritis
• Constipation
• Bladder/urine infection
• Pelvic infection
• Ectopic pregnancy

Question 7

What investigations are carried out for suspected appendicitis?

Answer 7

• ESR ↑
• CPR ↑
• Pregnancy test
• Urine dipstick – rule out bladder infection
• Ultrasound
• CT
• Abdominal US

Question 8

What are the surgical treatments for appendicitis?

Answer 8

• Laparoscopic appendectomy
• Traditional appendectomy – perforated appendix, 1st trimester of pregnancy, previous abdominal surgery, tumours in GI tract

Question 9

What are the pharmacological treatments for appendicitis?

Answer 9

• Fluids
• IV Antibiotics
• Analgesia

Question 10

What are the non pharmacological treatments for appendicitis?

Answer 10

None as MEDICAL EMERGENCY