Acute appendicitis

Acute appendicitis:
Inflammation of the vermiform appendix. Most common surgical emergency.

Occurs when appendix becomes inflamed from ulceration – caused by faecal mass, foreign body, stricture, viral infection.

Clinical features – initially a central abdominal colic, then shifts to right iliac fossa; fever; tachycardia; coughing painful; shallow breaths; vomiting
Positive psoas sign – attempt to raise right thigh against examiners hand on right knee  pain
Positive obturator sign – flex right hip and knee  rotate leg internally  pain

If left untreated  abscess, perforation, peritonitis  death

Differential diagnosis – ectopic pregnancy; food poisoning; diverticulitis; perforated ulcer; cystitis; Crohn’s disease

Complications – perforation  ingested contents spill into abdominal cavity  peritonitis

Management – appendicectomy is only effective treatment

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