Appendicitis Flashcards Preview

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Flashcards in Appendicitis Deck (10):
1

Peak incidence of appendicits at...?

10-12yo

2

What is the classical presentation of appendicitis?

• Abdominal pain lasting more than 4 hours 
• Periumbilical pain shifting to RIF 
• Diarrhoea 
• Anorexia 
• Lying still 
• Pallor 
• Foetor 
• Low-grade fever 
• Guarding 
• Other signs of peritonism

3

What are some atypical presentations of appendicitis?

• Retrocaecal appendicitis
• Vague non-localizing RIF pain with deep RIF tenderness – often without guarding

• Pelvic appendicitis
• Lower abdominal pain and tenderness
• Urinary symptoms
• Small volume diarrhoea

• Perforated appendicitis
• Presents with generalised peritonitis
• Risk of perforation greater in young children
• Communication difficult
• Less omental localization

4

What is retrocaecal appendicitis often mistaken for?

mesenteric adenitis = self-limiting inflammation of mesenteric lymph nodes in RLQ

5

What is pelvic appendicitis often mistaken for?

Gastroenteritis

6

What is perforated appendicitis often mistaken for?

Viral illness

7

What Ix might you do for appendicitis?

• FBE looking for neutrophilia 
• Plain AXR 
• Abdominal U/S: thickened, non-compressible appendix with increased blood flow 
• No routine role for CT 

8

What are some common DDx for appendicitis?

• Gastroenteritis 
• Mesenteric adenitis 
• UTI 
• RLL pneumonia 
• Testicular torsion  
• Strangulated inguinal hernia 

9

Complications of appendicitis

• Appendix mass 
• Abscess 
• Perforation  

10

What must you do before appendicectomy?

• ***Correct dehydration and electrolyte disturbance before surgery (replace half of fluid deficit before theatre)