5. Acute Appendicitis - Sarm

• treatment for appendicitis?


  appendectomy
• frequency of appendicitis?

  rare in infants but more common in childhood
• Appendicitis can maybe be due to diet?

  • foreign bodies
  • parasites
• appendicitis is due to obstruction of narrow appendiceal lumen

  • due to
  • fecal matter
  • hyperplasia of lymphoid follicles - due to infection
• early stage of appendicitis - congestive

  1. obstruction of appendiceal lumen will lead to accumulation of mucus or fluid and bacterial proliferation
  2. accumulation leads to intra-luminal pressure causing distention of appendix
  3. visceral afferent nerve fibers will perceives periumbilical or epigastric pain
• suppurative appendicitis

  • increasing intraluminal pressure will obstruct lymphatic and venous drainage
  • bacteria will spread
  • the inflamed serosa comes in contact with parietal peritoneum
  • causing pain in right lower quadrant
• gangrenous appendicitis

  • increase of intramural pressure leading to arterial compromised
  • leading to thrombosis
• where is pain in early appendicitis?

  periumbilical or epigastric pain
• Ruptured appendicitis pain is localized or generalized peritonitis
• Suppurative appendicitis pain - inflamed serosa cause shift of pain to right lower quadrant
• Continuous pressure on gangrenous area will lead to rupture appendicitis
• Localized peritonitis may produce

  • local abscess
  • phlegmon
• Generalized peritonitis can lead to sepsis
• appendicitis is usually within 24 hours

  1. initially - periumbilical pain
  2. shift to right iliac fossa
• ** Appendicitis - the pt needs to be anorexic

  • they are not hungry
• early or congestive appendicitis - periumbilical or epigastric pain

  • mild pain - lasting 4-6 hours
• Appendiceal rupture occurs?

  distal to obstruction
• if pregnant - appendix will go higher and lateral
• Appendicitis - CBC - see?

  neutrophilia - high