Wednesday, 30 May 2012

Acute appendicitis












One of the commonest surgical emergencies.


Sudden appearance of signs n symptoms of appendicitis called acute appendicitis.
Appendicitis- inflammation of the appendix..a vestigial organ.


Aetiology –

Racial and dietary factors-  common in white races, young males affected more often. Diet rich in meat and low in fibre precipitates the condition.


Familial susceptibility- related to having a long retrocaecal appendix, in which blood supply diminished to thedistal portion hence precipitates appendicitis.


Socioeconomic status- common in middle class and rich people.


Obstructive theory- obstructiob due to faecoliths, worms, ova , cysts.


Non-obstructive theory- due to bacteria such as e.coli , enterococci, proteus, pseudomonas etc.






Symptoms-





Pain- severe,colicky initially felt in umbilical region due to distension of appendix. Shifting pain of acute appendicitis present.
Vomiting.
Fever low grade.
Haematuria
Constipation.




Signs-


Cough tenderness.
Tenderness and rebound tenderness at mc burney’s point.
Guarding and rigidity in right iliac fossa.
Palpation of left liac region of abdomen produces pain in the right iliac region.
Features of generalized peritonitis present only when there is perforation.
Tenderness in right rectal wall in rectal examination.


CT scan is the investigation of choice.

Other investigations-


Total wbc count
Plain x-ray abdomen erect.
Abdominal ultrasound.


Treatment-



Emergency appendicectomy.
Laparoscopic appendicectomy.




Complications of acute appendicitis-


Rupture of appendix.
Appendicular mass.
Appendicular abcess.




There is no prevention from this disease few steps which can help in prevention from complications from acute appendicitis are-


Take a high fiber diet.
Look after the symptoms earlier and consult a doctor immediately so that the condition can be prevented from being worse.

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