Appendicitis -Most common between 10-30yrs; but can occur at any age; rare in infants and older adults
-men more at risk
- Diets low in fiber, high in fat, refined sugars, & other carbs at increased risk.
- Obstructio
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Appendicitis -Most common between 10-30yrs; but can occur at any age; rare in infants and older adults
-men more at risk
- Diets low in fiber, high in fat, refined sugars, & other carbs at increased risk.
- Obstruction of appendix is cause of majority of appendicitis
- contributing factors: Intra-abdominal tumors, positive family hx
- Recent roundworm infection or viral GI infection -Dx made clinically, based primarily on H&P exam
- Classic presentation includes acute onset of mild to severe colicky, epigastric, or periumbilical pain
- Pain is vague at first then localizes within 24hrs to RLQ
- Pain exacerbated by walking\coughing
- Men may feel radiated pain in testes
- Abd muscle rigidity, N\V, anorexia
- Mildly elevated temp 99-100F common
- If RLQ accompanied by shaking chills, perforation should be suspected
- Older adults may present with weakness, anorexia, abd distention, mild pain leading to delayed dx and increased
morbidity. -May have HTN\tachy proportional to pain\symptoms
-When lying flat, may flex R knee to relieve tension in abd muscle
-Pain with palpation in abd, diffuse in early stages. Localized to RLQ later
-Positive for rebound pain; ask pt to cough to localize pain location
-Sudden cessation of pain means perforation and is ER -Labs are not diagnostic and nonspecific
-Women should have urine human chorionic gonadotrophin to r\o ectopic pregnancy
- +Rovsing’s Sign- deep palpation & release in LLQ causes rebound pain in RLQ
- +Psoas Sign- lift R leg against gentle pressure causes pain
- +Obturator Sign- flex R hip & knee and slowly rotate internally causes pain
- +McBurney’s Sign- pain with pressure applied to point between umbilicus & ilium
- x-ray\CT helpful when paired with positive H&P findings -Surgical; preoperative care, NPO, correction of fluid\electrolyte imbalances
-Avoid narcotics
-Atb with 3rd gen cephalosporin; Ex: ampicillin, gentamycin, flagyl -F\U with surgeon
-Ambulation after surgery
-Adv diet when bowel sounds return
-Return to hosp with s\s of infection
-Avoid heavy lifting for at least 2 wks
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