Appendicitis

Question 1

What is appendicitis

Answer 1

Inflammation of the appendix

Question 2

Clinical presentation of appendicitis

Answer 2

Pain presents from umbilicus -> right iliac fossa, tender with guarding
General: Nausea, localised tenderness, diarrhoea/constipation, pyrexia

Question 3

Pathophysiology of Appendicitis

Answer 3

Obstruction of the lumen causes gut flora to invade the appendix wall -> becomes inflamed and infected.
This is liable to rupture, letting infected and faecal matter into the peritoneal cavity -> life threatening peritonitis.
Alternatively, can form a Appendix abscess where the omentum localises the infection. This presents as a tender mass.

Question 4

Aetiology of Appendicitis

Answer 4

Formation of a faecolith (hard discreet mass of inspissated faeces) that obstructs the lumen of the appendix.

Question 5

Epidemiology of Appendicitis

Answer 5

About 10% of population will develop it

Common between 10 and 20 years tho can onset at any age

Question 6

Diagnosis of Appendicitis

Answer 6

Inflammation markers (CRP, ESR, white cell count) raised but not specific. 
CT is gold standard.

Question 7

Treatment of Appendicitis

Answer 7

Surgical removal, open or laparoscopically. Appendix mass can be treated with IV fluids and antibiotics, and later appendectomy.

Question 8

Complications of Appendicitis

Answer 8

Peritonitis

Appendix abscess