Appendicitis Flashcards Preview

Surgery > Appendicitis > Flashcards

Flashcards in Appendicitis Deck (11):
1

Different positions of the appendix

Pre-ileal – Anterior to the terminal ileum – 1 o’clock.
Post-ileal – Posterior to the terminal ileum – 2 o’clock.
Sub-ileal – Parallel with the terminal ileum – 3 o’clock.
Pelvic – Descending over the pelvic brim – 5 o’clock.
Sub-caecal – Below the cecum – 6 o’clock.
Paracaecal – Alongside the lateral border of the cecum – 10 o’clock.
Retrocaecal – Behind the cecum – 11 o’clock.

2

Most common positions of the appendix

Retrocaecal and subileal

3

Arterial and venous supply of the appendix

Appendicular artery (from Ileocolic artery -> SMA) and appendicular vein

4

Nerve supply for appendix

Superior mesenteric plexus (ileocolic branch)

5

Appendicitis

Acute inflammation of the appendix

6

Typical presentation of appendicitis

Acute abdominal pain starting in the mid-abdomen and later localising to the right lower quadrant.

Associated fever, nausea and vomiting, anorexia

7

Common causes of appendicitis

Young due to increase in lymphoid tissue which occludes the appendix
Faecolith (hard faecal mass)

8

Most common bacteria in the appendix

Escherichia Coli and Bacteroides Fragilis

9

Signs for appendicitis

Rovsing's sign- Pressing the left side of the abdominal cavity and eliciting pain in right lower quadrant.

Psoas sign- Extending the right thigh on left lateral position elicits pain in right lower quadrant.

Obturators sign- Pain is elicited at right lower quadrant of abdomen by internal rotation of the flexed right thigh.

10

Management of appendicitis

NBM
IV Fluids
Appendectomy

11

Alvarado score

RLQ tenderness (2)
Elevated temp 37.3 (1)
Rebound tenderness (1)
Migration of pain to RLQ (1)
Anorexia (1)
Nausea and vomiting (1)
Leukocytosis <10000 (2)
Leukocyte left shift (1)

>5 unlikely >7 probable