appendicitis

Question 1

define appendicitis

Answer 1

Inflammation of the appendix

Question 2

what is the pahthophysiology behind appendicitis?

Answer 2

1. appendix lumen obstructed
2. Gut flora invade appendix wall , fluid and mucus build up
3. Wall becomes inflamed + infected
4. Pressure in appendix increases
5. increased rupture risk
6. Leads to oedema , ischaemia , necrosis , inflammation and SBP

Question 3

What are the causes behind appendicitis?

Answer 3

lumen obstruction
1. faecolith- stones made of faeces
2. lymphoid hyperplasia ( of Peyer patches)
3. filarial worms
4. bacteria

Question 4

what are the complications associated with appendicitis?

Answer 4

-SBP
· Peri-appendical abscess

Question 5

what is the epidemiology for appendicitis?

Answer 5

Peak age 10-20 years
· Males
· Most common surgical emergency

Question 6

what are the symptoms of appendicitis?

Answer 6

1. Umbilical pain
   ↳ can progress to RIF (right iliac fossa)
2. Rebound tenderness+ abdo guarding
3. Pyrexia (fever) N + V , diarrhoea /constipation

Question 7

what are the signs of appendicitis?

Answer 7

1 rosving
-> press on RLQ>- causes LLQ pain
2 obturator
↳internal rotation of thigh pain
3 PSOAS
↳> lying on left side , painful toextend right leg

Question 8

how is appendicitis diagnosed?

Answer 8

1 CT (gold standard)
↳ of abdomen + pelvis
2 Pregnancy test
↳ rule out ectopic pregnancy
3 F B C
- High WBC, High CRP, High ESR

Question 9

how is appendicitis treated?

Answer 9

Antibiotics and then
appendectomy
↳ must drain abscesses first