Appendicitis

A Podmedics and Oxford University Press podcast on this important surgical condition.

 

Lecture by

Video Duration: 12 minutes

  • Appendicitis
    Created by Dr Ed Wallitt
    General
    Epidemiology

    "Inflammation of the vermiform appendix"

    Very common. 6% lifetime occurence. Max peak during childhood

    Pathology

    Obstruction of the lumen of the appendix leading to swelling and venous congestion. May result in necrosis.

    Top three causes

    Faecolith, lymphoid hyperplasia and tumours (think if older)

    Clinical Features
    Symptoms

    Nausea, vomiting and anorexia

    Central colicky abdominal pain that moves to RIF.


    Signs

    Unwell +/- signs of sepsis. Foetor oris

    Guarding and tenderness over McBurney's point.

    Consider Rovsing's sign, Psoas sign and Cope sign.

    Investigations
    Cultures

    Urine dipstick + pregnancy test

    Bloods

    FBC, CRP, amylase, G&S, clotting

    Imaging

    Ultrasound

    Scopic/Biopsy

    Diagnostic laparoscopy

    Functional

    None

    Treatment
    Conservative

    NBM, fluids, analgesia, antibiotics (debated!)

    Medical

    None

    Surgical

    Appendicectomy (open or lap)

    May be actively observed if diagnosis uncertain