Please enable JavaScript.
Coggle requires JavaScript to display documents.
Appendicitis (Clinical Presentation (Pain in the umbilical region…
Appendicitis
Clinical Presentation
-
Examination of abdomen reveals tenderness in the right iliac fossa with guarding due to localised peritonitis
-
-
-
-
Pain in the umbilical region (periumbilicial pain) that migrates to the right iliac fossa, specifically McBurney's point after a few hours
Early inflammation irritates the structure and walls of the appendix, so there is a referred pain to the mid-abdomen (periumbilical pain)
As the inflammation progresses, it irritates the PARIETAL PERITONEUM, so the somatic pain settles at McBurney's point
-
-
-
-
Pathophysiology
This leads to oedema, ischaemia, necrosis and perforation as well as INFLAMMATION
If the appendix ruptures then infected and faecal matter will enter the peritoneum resulting in life threatening peritonitis
Occurs when the lumen of the appendix becomes obstructed by lymphoid hyperplasia, filarial worms or a faecolith resulting in the invasion of gut organisms into the appendix wall
Complications
Appendix mass
When an inflamed appendix becomes covered in momentum (thus forming a mass) - ultrasound of CT can help diagnose
-
-
-
Key Points
-
Located at McBurney's point which lies 2/3 of the way from the umbilicus to the Anterior Superior Iliac Spine (ASIS)
Treatment
Surgical
If appendix mass is present, the patient is usually treated with IV. fluids and antibiotics until mass disappears over a few weeks - appendicectomy is recommenced later to prevent further acute episodes
-
-