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9 Cards in this Set

  • Front
  • Back
MECHANISM: Acute Appendicitis
Luminal obstruction (Fecaliths; or less commonly gallstones, tumour, mass of worms)
-> Iscahemic injury (vascular compression) + luminal stasis
-> Bacterial proliferation
-> Inflammation
-> Eedema, neutrophilic infiltrate
Acute Appendicitis: Pathology
Congestion + neutrophilic infiltrate

Glistening serosa -> Dull, granular, erythematous

Dx: Netrophilic infiltration of muscularis propria
Acute Appendicitis: Complications
Ganrenous necrosis -> rupture + suppurative peritonitis
Acute Appendicitis: Clinical features

One is a classical finding
Typical: Periumbilical pain
-> Localises to right lower quadrant

Followed by:
Nausea & Vomiting
Low fever
Mildly raised peripheral white cell count

Classical finding: McBurney's sign

Symptoms/signs often absent
Acute Appendicitis: Classical finding
Classical finding:
McBurney's sign
(deep tenderness, 2/3 from umbilicus to right ASIS [McBurney's point])
Acute Appendicitis: Unusual pain referrals
Retrocaecal appendix can refer pain to flank or back

Malrotated colons can produce pain in unusual areas
Acute Appendicitis: Tx
Low risk, risk-benefit ratio good
Acute Appendicitis: Complications
Delayed resection of inflamed appendix:
Appendiceal perforation
Pyelophlebitis (inflam of veins of renal pelvis)
Portal venous thrombosis
Liver abscess
Appendiceal tumour: Carcinoid

Clinical presentation
Carcinoid = Most common tumour of appendix

Usu affects most distal tip of appendix -> solid bulb to 2-3cm diameter

*Characteristic yellow colour

Metastasis rare