Class notes
Acute appendicitis
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Pathophysiology Symptoms Diagnosis Treatment of acute appendicitis in adults
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T incidence 10 lo20g lo 2
rare a
y
Symptoms
Periumbillical pain progressing to the RIF
Tachycardia Fever Vomiting Nausea
Anorexia
Signs
Abdo gaurding rebound tenderness in RIF
Rousing's sign Pain in the Rif when the LIF is pressed
Psoas sign Pain on extending on hip Cretrocaecal appendix
Pathogenesis
luminal obstruction to
Typically causedby direct usually 2
faecolith Stoney mass of compacted faeces or lymphoid
hyperplasia impacted stool or
rarely an append ice at or caecal
tumour
When obstructed Commensal bacteria in the appendix can multiply
acute inflammation Reduced venous drainage and localised
resulting in
inflammation T pressure within the appendix which ischaemia
If left untreated ischaemia within the appendiceal
wall Necrosis which in turn Perforation
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