Appendicitis

Question 1

what is it

Answer 1

surgical emergency where there is inflammation of appendix

usually due to irritation or faecal obstruction

Question 2

what causes it

Answer 2

unknown 
obstruction of lumen with faecolith 
bacterial 
viral 
parasites

Question 3

what are symptoms

Answer 3

epigastric pain --> RIF (mcburneys point)
anorexia 
nausea 
vomiting 
low grade fever 
rovings (pain in RIF when LIF palpated)

Question 4

what is pathology

Answer 4

acute inflammation involving muscle coat, mucosal ulceration, serosal congestion, exudate, pus in lumen

Question 5

what are signs

Answer 5

mild pyrexia (never high temp initially)
mild tachycardia
localised pain in RIF
guarding 
rebound

Question 6

how is it diagnosed

Answer 6

clinical diagnosis 
USS useful in women in kids
AXR to exclude other causes 
bloods (important CRP, WCC)
urinalysis

Question 7

how is it treated

Answer 7

laparoscopic appendectomy

IV fluids and antibiotics if abdominal mass

Question 8

what are the complications

Answer 8

peritonitis
rupture 
abscess 
fistula
sepsis 
liver abscess