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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Article Home Adult and Senior Health Acute appendicitis

Acute appendicitis

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Appendicitis is a condition in which the inflammation of the appendix is present. Mortality is high due to peritonitis and shock. An acute form of appendicitis is called as rumbling appendicitis.

 

 

Causes of appendicitis

  • Foreign bodies
  • Trauma
  • Intestinal worms
  • Lymphadenitis
  • Obstructing fecolith

Signs and symptoms of appendicitis

  • Pain in the right iliac fossa
  • Fever
  • Loss of appetite
  • Tenesmus or downward urge
  • Nausea
  • Vomiting
  • Diarrhea
  • Increased frequency of micturition
  • Rebound tenderness
  • Tenderness in the right iliac fossa
  • Abdominal rigidity
  • Rovsing’s sign positive: There will be palpation of the left iliac fossa. Pressure over the descending colon causes pain in the right lower quadrant of the abdomen.

Investigations

  • Physical examination
  • Urine analysis
  • Ultrasound scan abdomen
  • Doppler sonography
  • CT scan of the abdomen
  • Complete blood investigations show leucocytosis
  • Laparoscopy
  • Barium enema

 

Treatment of appendicitis

  • Antibiotics
  • Appendicectomy: It is a surgical procedure in which the appendix is removed.
  • Laparatomy
  • Most patient recover easily with surgical treatment.
  • Alvarado score

 

 Right iliac fossa which is migratory -
 Anorexia                  -                 
 Nausea and vomiting -
 Tenderness in the right iliac fossa -
 Rebound tenderness -
 Fever -
 Increased white blood cells -
 Segmented neutrophils like shift to left -

 

Total points  while a score of 7 is strongly predictive of acute appendicitis.

Complications of appendicitis

  • Peritonitis
  • Sepsis
  • Perforation of the appendix
  • Wound infection
  • Abscess