Appendicitis

Question 1

What is appendicitis?

Answer 1

Inflammation of the appendix, it is the MC cause of acute abdominal pain in children

Question 2

Aetiology

Answer 2

Obstruction of the appendix lumen (faecolith, lymphoid hyperplasia, rarely tumour) → bacterial overgrowth → inflammation

Question 3

3 main RF

Answer 3

1. Age > 5 (MC 10-19 YO)
2. Male (slightly higher than F)
3. FH

Question 4

4 sx

Answer 4

1. Periumbilical pain migrating to the right lower quadrant
2. N+V
3. Anorexia
4. Fever

• Potential diarrhoea or urinary sx

Question 5

4 signs

Answer 5

1. Tenderness at McBurney’s point
2. Rebound tenderness/guarding
3. Rovsing’s sign
4. Fever + tachycardia

Question 6

Ix

Answer 6

Mainly clinical dx - US + may perform FBC (high WCC) + CRP

CT if uncertain or complicated

Question 7

Mx

Answer 7

1. Surgical appendicectomy (laparoscopic is preferred)
2. IV abx if complicated

Question 8

4 complications

Answer 8

1. Perforation - peritonitis/abscess
2. Sepsis
3. Wound infection after surgery
4. Bowel obstruction (adhesions)

Question 9

What is Rovsing’s sign?

Answer 9

Rovsing’s sign: Pain in the right lower quadrant when the left lower quadrant is palpated, suggesting appendicitis.