APPENDICITIS

DEFINITION

Condition in which appendix become inflamed.

HOW TO IDENTIFY CLINICALLY

  • Pain- Migratory pain (initial around umbilicus later in the right iliac foss)
  • Vomiting
  • Fever

CHARACTERESTIC FEATURES/ DIAGNOSTIC FEATURS

  • Abdominal pain
  • Swollen belly
  • Constipation
  • Diarrhea
  • Inability to pass gas
  • Loss of appetite
  • Low grade fever
  • Nausea and vomiting
  • Tenderness & reborn tenderness in right iliac fossa.

LAB DIAGNOSIS

Gold test- contrastenhance computed tomography(CECT)

Initial test- abdominal X-ray, abdominal ultrasound,  MRI,  CT-scan, urine test,  blood test

WARNING SIGNS

  • Peritonitis
  • Abdominal guarding
  • Painful abdomen
  • Distended tenderness
  • Reboud
  • Absent bowl sound

INITIAL MANAGEMENT

  • Nill by mouth
  • Insertion of Rule’s tube if vomiting
  • I.V. Fluids
  • I.V. antibiotics- ofloxacin + metrogyl

DEFINITIVE MANAGEMENT

  • If no appendicular mass-

SURGERY

  • Laparoscopic appendectomy/ open appendectomy.
  • If appendicular mass-
  • Conservative management (NMB, IV Fluids,IV antibiotics)
  • Following interval appendectomy after 6 months.

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