Appendicits

Question 1

Presentation?

Answer 1

Initially central, colicky abdominal pain to vomiting to  pain in RIF.
May have altered bowel habit or urinary frequency

Question 2

On examination?

Answer 2

Signs of septic shock, tachycardia, fever, distress. Tenderness in RIF (rebound) due to peritonitis.

Rovsing’s sign – pain in RIF when pressing LIF

Question 3

Diagnosis?

Answer 3

Exclude pregnancy and UTI
Bloods
Urine
US

Question 4

Mx?

Answer 4

ABDE
IV access
IV opioid/antiemetic
NBM - refer to surgeons