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Infor Acute appendicitis PowerPoint Presentation

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Published on : Jan 08, 2015
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Slide 1 -

APPENDICITIS The classic presentation is periumbilical pain that migrates to the right lower quadrant RLQ. Mc Burney's point one-third the distance between the anterior or anterosup.iliac spine and the umbilicus-on a line connecting the two.This is a typical pain of maximal tenderness in appendicitis. Mc Burney describe the point named after him in 1889 at the Roosvelt Hospital in New York. He was a surgeon from N.Y who,in collaboration with a surgeon named Fitz,coined the term “appendicitis”in classic papers published in 1886 and 1889.

Slide 2 -

What layers does the surgeon encounter on exposing the appendix through a Rocky-Davis incision? Answer is; 1.skin 2.subcutaneous fat 3.Aponeurosis of the external oblique muscle 4.internal oblique muscle 5.transversalis fascia 6.muscle 7.peritoneum

Slide 3 -

The typical laboratory findings of a patient with appendicitis: White blood cell count-12.000-14.000. Negative urinalysis(no white cells).Negative pregnancy test.There is no test for appendics.

Slide 4 -

This is the groups of patient at higher risk of perforated appendicitis very young patients less than 2 years old and elderly patients over 70 years old who exhibit dampered abdominal innervation and present late diabetic patients, who also present late becuse of diabetic visceral neuropathy,patients on steroids, steroids mask everything.

Slide 5 -

Blood supply to the appendix and right colon is the ileocolic and right colic arteries. Ultrasound can be both negatively and positively helpful. It is nice to see a perfectly normal right fallopian tube and ovary. It is also reassuring to see an inflamed,edematous appendix. ‘'White worm” a normal appendix.

Slide 6 -

THE DIFFERENTIAL DIAGNOSIS OF THE RIGHT LOWER QUADRANT PAIN: MERCKEL'S DIVERTICULITIS DIVERTICULITIS ECTOPIC PREGNANCY CROHN”S DISEASE TUBOOVARIAN ABSCESS PELVIC INFLAMMATORY DISEASE CARCINOID TUMOR CHOLECYSTITIS

Slide 7 -

CLASSICAL APPENDICITIS symptoms-an attack of appendicitis usually begins with epigastric or periumbilical pain associated with 1-2 episodes of vomiting.Within 2-12 hours the pain shifts to the right lower quadrant,where it persists as a steady sorness which is aggravated by walking or coughing.There is anorexia,moderate malasise,slight fever,contipation is usual,diarrhea occurs occasionally.The patient can often place his finger preciselly on this area of pain of maximum tenderness(especially if asked to accentuate the soreness by coughing) We have a light percussion and we have a rebound tenderness and spasm of the overlying abdominal muscles are usually present.

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