1. Acute appendicittis
Complaints : -
- Acute pain in the right iliac region. (kosher vilkovich symptom:pain start in umblicle region and going
to right iliac region.
. Fever.
.Vomting 1 time.
.Nausia.
.Weakness.
Anamnsis Morbi:-
-Acute begening.
-2Hours
.Analgesics .
Anamnsis Vita :-
. no provocative factor
Physical Examination :-
-Visual inspiction :
.Pale Skin
.Asymmetric abdomin .
.Dry tounge.
Palpation :-
-Rovsing -Palpation in the left region and pain in the right iliac region.
-Bartomier - Michelson - Symptom - Palpation in right iliac region while patient on the left side.
-Vaskresensky (Shirt Symptom) : By left hand of the doctor pull the patient shirt and by right hand fast
and press moderat on the right side of the abdominal and the patient feel pain on the right iliac
region .
-Obrastov : palpation on the right iliac region with lefting the right leg and the patient feel pain on the
right iliac region.
2. Percussion : -
Razdolsky - Left iliac region - epigastrium
- Right iliac Region - epigatrium
Auscultation :-
No Change.
Laboratory :-
.General blood count - Leukocytosis with left shift formula .
.General urine - Protenuria , Leukocytosis.
Instrumental : -
.Ultra Sound -Thinckning of the wall of appendix.
-Enlargement of appendix.
.X-Ray - Enlargemnet of appendix.
3. Deffrential Duagnosis : -
Acute Appendsitis Acute Cholestits
Complaints Acute abdominal pain on the right iliac , No
irradiation.
Acute abdomenal pain under ribs, irradiation : Right
Scapula
Anamnesis morbi - Acute Beginning
- 2 Hours
- Analgesiscs
- Acute Beginning
- 2 Hours
- Analgesiscs
Anamnsis vita No provacative Factor. - Alcohol
- Fatty food
- Spice food
Labaratory Test Blood Test : - Urine test :
-Leukocytosis Protenurian
-Biochemical , No Change
Blood Test :-
-Leukocytosys with left shift formula
-A2T,AST Amylase
-Alkaline phosphatase glucose.
Treatment :
- Urgent Hospetalazation
- Urgent operation
- Appendoctomy
- Medication (antibiotic)
