ROJoson PEP TALK: RLQ ABDOMINAL PAIN & APPENDICITIS - Fundamentals and Generalities in Medical Management

1. Empowerment
objective - for
laypeople to have an
understanding of
the FUNDAMENTALS
and GENERALITIES in
the MEDICAL
MANAGEMENT of
RLQ ABDOMINAL
PAIN and
APPENDICITIS.
Health Disorder
Course–
Fundamentals
and
Generalities in
Medical
Management
of RLQ
ABDOMINAL
PAIN and
APPENDICITIS
April 2, 2022
1400H - 1500H
Via Zoom
RLQ – Right Lower Quadrant

2. Empowerment
objective - for
laypeople to have an
understanding of
the FUNDAMENTALS
and GENERALITIES in
the MEDICAL
MANAGEMENT of
RLQ ABDOMINAL
PAIN and
APPENDICITIS.
Health Disorder
Course–
Fundamentals
and
Generalities in
Medical
Management
of RLQ
ABDOMINAL
PAIN and
APPENDICITIS RLQ – Right Lower Quadrant
ROJoson PEP Talk
I have a Patient
Empowerment
Program in which I
like to empower the
lay people or
patients to take
control in the
management of
their health.

3. There are 3 courses
in the PEP Talk.
I completed the Core
Course on October 9,
2021.

4. From October 23,
2021 onwards, I have
been tackling Health
Disorder and Health
Issue Courses. This
may take 3 years or
longer.

5. Empowerment
objective - for
laypeople to have an
understanding of
the FUNDAMENTALS
and GENERALITIES in
the MEDICAL
MANAGEMENT of
RLQ ABDOMINAL
PAIN and
APPENDICITIS.
Health Disorder
Course–
Fundamentals
and
Generalities in
Medical
Management
of RLQ
ABDOMINAL
PAIN and
APPENDICITIS RLQ – Right Lower Quadrant
My PEP TALK today
is entitled:
Fundamentals and
Generalities in
Medical
Management of RLQ
ABDOMINAL PAIN
and APPENDICITIS.
This is part of the
Health Disorder
Course.

6. Contents of ABDOMINAL DISORDERS
[OVERVIEW]
• What is an abdominal disorder?
• What are the different types of abdominal
disorders?
• What are the causes of abdominal disorders?
• How common are the abdominal disorders?
• Clinical diagnosis of abdominal disorders?
• Paraclinical diagnostic procedures for
abdominal disorders?
• Basic treatment modalities for abdominal
disorders?
Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
March 19, 2022
1400H - 1500H
Via Zoom
• Abdominal Pain
• Abdominal Mass
• Abdominal Obstruction
• Abdominal Bleeding
• Jaundice

7. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
March 26, 2022
1400H - 1500H
Via Zoom
Contents of ABDOMINAL PAIN
[OVERVIEW]
• What is an abdominal pain?
• What are the different types of abdominal
pain?
• What are the causes of abdominal pain?
• How common are the abdominal pain?
• Clinical diagnosis of abdominal pain?
• Paraclinical diagnostic procedures for
abdominal pain?
• Basic treatment modalities for abdominal
pain?

8. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
April 2, 2022
1400H - 1500H
Via Zoom
Contents of RLQ ABDOMINAL PAIN
and APPENDICITIS
• What is a RLQ abdominal pain?
• What are the different types of RLQ abdominal
pain?
• What are the causes of RLQ abdominal pain?
• How common are RLQ abdominal pain?
• Clinical diagnosis of RLQ abdominal pain?
• Paraclinical diagnostic procedures for RLQ
abdominal pain?
• Basic treatment modalities for RLQ abdominal
pain?
• Management of APPENDICITIS

9. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
Definition of Terms in Title AND Delimitation of
Coverage of Talk:
Fundamentals – simplest and essential facts and
theories which can serve as a basis or foundation
and support for advanced information
Generalities – general statements of info, not
covering specifics and details
Medical Management – diagnosis and treatment
by physicians

10. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• What is a RLQ abdominal pain?

11. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• What is a RLQ abdominal pain?
RLQ stands for right lower quadrant.
RLQ abdominal pain means pain or unpleasant
sensation in the right lower quadrant of the
abdomen. RLQ is the location of the pain.
What is the
implication of the
RLQ abdominal pain?
All the tissues and
organs in the RLQ
area could be the
source of the RLQ
abdominal pain.
• Abdominal wall
• Peritoneal lining
• Internal
abdominal organs
in the area

12. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• What are the different types of RLQ abdominal
pain?

13. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• What are the different types of RLQ abdominal
pain?
Essentially, the different types of RLQ abdominal
pain will be based on the origin of the unpleasant
sensation on/in the area:
• abdominal wall
• lining of the abdominal cavity or
peritoneum
• solid organs
• hollow organs inside the abdominal
cavity in the RLQ

14. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• What are the different types of RLQ abdominal
pain?
Essentially, the different types of RLQ abdominal
pain will be based on the origin of the unpleasant
sensation on/in the area:
• abdominal wall
• lining of the abdominal cavity or
peritoneum
• solid organs
• hollow organs inside the abdominal
cavity in the RLQ
ROJoson GENERAL
CLASSIFICATION OF
TYPES of unpleasant
sensation that can
used as CUES:
• Abdominal wall –
constant,
superficial
• Peritoneal lining –
constant, deeper
• Sold organs –
constant, deep
• Hollow organs –
crampy or colicky

15. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• What are the causes of RLQ abdominal pain?

16. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• What are the causes of RLQ abdominal pain?
All the tissues and organs in the RLQ area could
be the source of the RLQ abdominal pain.
• Abdominal wall
• Peritoneal lining
• Internal abdominal organs in the area (hollow
and solid organs)
• Appendix
• Right colon (ascending colon)
• Small intestines
• Right ureter /urinary bladder
• Female reproductive organs (right ovary,
right fallopian tube, uterus)

17. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• What are the causes of RLQ abdominal pain? • Abdominal wall
• Peritoneal lining
• Internal abdominal
organs in the area
(hollow and solid
organs)
• Appendix
• Right colon
(ascending colon)
• Small intestines
• Right ureter
/urinary bladder
• Female
reproductive
organs (right ovary,
right fallopian
tube, uterus)

18. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• What are the causes of RLQ abdominal pain?
All the tissues and organs in the RLQ area could
be the source of the RLQ abdominal pain.
• Abdominal wall
• Peritoneal lining
• Internal abdominal organs in the area (hollow
and solid organs)
• Appendix
• Right colon (ascending colon)
• Small intestines
• Right ureter /urinary bladder
• Female reproductive organs (right ovary,
right fallopian tube, uterus)
All kinds of medical
conditions and
diseases in these
organs can cause
abdominal pain.
• Inflammation
• Tumors
• Stones
• Hormonal changes

19. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Clinical diagnosis of RLQ abdominal pain?

20. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Clinical diagnosis of RLQ abdominal pain?
All kinds of medical
conditions and
diseases in the tissues
and organs in the RLQ
can cause abdominal
pain.
• Inflammation
• Tumors
• Stones
• Hormonal changes
Processes used in clinical diagnosis of RLQ
abdominal pain:
• Pattern recognition process means realization
that the patient’s presentation conforms to a
previously learned picture or pattern of
disease.
• Prevalence process means choice of a diagnosis
is based on the frequency of occurrence of the
disease in a certain locality, in a certain age and
sex group, and in the affected organ and
system.

21. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Clinical diagnosis of RLQ abdominal pain?
All kinds of medical
conditions and
diseases in the tissues
and organs in the RLQ
can cause abdominal
pain.
• Inflammation
• Tumors
• Stones
• Hormonal changes
TIPS:
BASIC EVALUATION METHODS:
• HISTORY TAKING – TO GET SYMPTOMS
• PHYSICAL EXAMINATION – TO GET SIGNS
CLINICAL DIAGNOSIS

22. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Clinical diagnosis of RLQ abdominal pain?
TIPS in evaluating / diagnosing RLQ ABDOMINAL
PAIN upon onset of pain (any unpleasant
sensation)
• Try to determine the type of pain as best as
you can.
• Feel for any associated symptoms like fever,
nausea, vomiting, diarrhea, etc.
• Recall any antecedent /precipitating events
that may lead to the pain.
• Monitor closely the pain – course and its
associated symptoms.
SYMPTOM-based
evaluation

23. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Clinical diagnosis of RLQ abdominal pain?
TIPS in evaluating / diagnosing RLQ ABDOMINAL
PAIN upon onset of pain (any unpleasant
sensation)
• Try to determine the type of pain as best as
you can.
• Feel for any associated symptoms like fever,
nausea, vomiting, diarrhea, etc.
• Recall any antecedent /precipitating events
that may lead to the pain.
• Monitor closely the pain – course and its
associated symptoms.
A simple classification
of pain that may have
diagnostic import:
Crampy / colicky pain
– hollow organ
involvement
Non-crampy / colicky
pain - may be from
any source even
hollow organ
involvement

24. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Clinical diagnosis of RLQ abdominal pain?
TIPS in evaluating / diagnosing RLQ ABDOMINAL
PAIN upon onset of pain (any unpleasant
sensation)
• Try to determine the type of pain as best as
you can.
• Feel for any associated symptoms like fever,
nausea, vomiting, diarrhea, urinary
disturbance, etc.
• Recall any antecedent /precipitating events
that may lead to the pain.
• Monitor closely the pain – course and its
associated symptoms.
Associated symptoms
may give clues to the
diagnosis such as
• Fever – an
inflammation /
infection may be going
on
• Vomiting – possible
obstruction
• Diarrhea – possible
enteritis
• Urinary disturbance –
possible bladder
problem

25. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Clinical diagnosis of RLQ abdominal pain?
TIPS in evaluating / diagnosing RLQ ABDOMINAL
PAIN upon onset of pain (any unpleasant
sensation)
• Try to determine the type of pain as best as
you can.
• Feel for any associated symptoms like fever,
nausea, vomiting, diarrhea, urinary
disturbance, etc.
• Recall any antecedent /precipitating events
that may lead to the pain.
• Monitor closely the pain – course and its
associated symptoms.
An antecedent /
precipitating event
may give clues to the
diagnosis such as
• History of recent
vehicular accident -
possible blunt
injury
• History of mense –
possible
dysmenorrhea

26. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Clinical diagnosis of RLQ abdominal pain?
TIPS in evaluating / diagnosing RLQ ABDOMINAL
PAIN upon onset of pain (any unpleasant
sensation)
• Try to determine the type of pain as best as
you can.
• Feel for any associated symptoms like fever,
nausea, vomiting, diarrhea, urinary
disturbance, etc.
• Recall any antecedent /precipitating events
that may lead to the pain.
• Monitor closely the pain – course and its
associated symptoms.
After onset,
monitoring closely the
course of the
abdominal pain may
give clues to the
diagnosis such as
• Over time, the type
of pain may be
clearer in character
to enable pattern
recognition of a
medical condition
or disease.

27. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Clinical diagnosis of RLQ abdominal pain?
TIPS in evaluating / diagnosing RLQ ABDOMINAL
PAIN upon onset of pain (any unpleasant
sensation)
• Try to determine the type of pain as best as
you can.
• Feel for any associated symptoms like fever,
nausea, vomiting, diarrhea, urinary
disturbance, etc.
• Recall any antecedent /precipitating events
that may lead to the pain.
• Monitor closely the pain – course and its
associated symptoms.
After onset,
monitoring closely the
course of the
abdominal pain may
give clues to the
diagnosis such as
• Over time, the
appearance of
associated
symptoms may
enable pattern
recognition of a
medical condition
or disease.

28. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Clinical diagnosis of RLQ abdominal pain?
TIPS in evaluating / diagnosing RLQ ABDOMINAL
PAIN upon onset of pain (any unpleasant
sensation)
PHYSICAL EXAMINATION
LOOK AND PALPATE
SIGN-based
evaluation

29. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Clinical diagnosis of RLQ abdominal pain?
SIGN-based
evaluation
TIPS:
BASIC EXAMINATION OF THE ABDOMEN:
LOOK AND PALPATE
• LOOK for unusual bulge particularly in the RLQ
that may suggest mass.
• LOOK for abdominal distention that may
suggest intestinal obstruction or mass.
• PALPATE for possible presence of mass.
• PALPATE for presence of tenderness (pain on
pressure) – if present, evaluate further.

30. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Clinical diagnosis of RLQ abdominal pain?
TIPS:
In looking for the SPECIFIC CAUSE of RLQ
ABDOMINAL PAIN,
use PATTERN RECOGNITION of a particular
medical condition or disease and PREVALENCE
process in those with similar presentation of
symptoms and signs.
• Primary clinical diagnosis: Most probable
• Secondary clinical diagnosis: Second most
probable
Clinical Diagnosis
General Statements:
RLQ abdominal pain
secondary to:
• Non-specific
cause
• Specific cause
(specify the
disease)

31. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Clinical diagnosis of RLQ abdominal pain?
TIPS:
In looking for the SPECIFIC CAUSE of RLQ
ABDOMINAL PAIN,
use PATTERN RECOGNITION of a particular
medical condition or disease and PREVALENCE
process in those with similar presentation of
symptoms and signs.
• Primary clinical diagnosis: Most probable
• Secondary clinical diagnosis: Second most
probable
If there are cues for
a specific disorder,
such as mass or
obstruction, then
specify the disorder
and then look for
the specific cause.

32. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Clinical diagnosis of RLQ abdominal pain?
If there are cues for
a specific disorder
and a specific
disease, then specify
the disorder and the
specific disease.
That will be the
diagnosis.
In patients with RLQ ABDOMINAL PAIN but
without clear-cut CUES for
• Abdominal mass
• Abdominal obstruction
and ABDOMINAL PAIN is mild and with no clear-
cut characteristics and with no CUES for a specific
disease whatsoever,
DIAGNOSIS is usually “Non-specific RLQ
abdominal pain”. [This has to be monitored
afterwards.]

33. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Clinical diagnosis of RLQ abdominal pain?
In patients with RLQ ABDOMINAL PAIN but
without clear-cut CUES for
• Abdominal mass
• Abdominal obstruction
and ABDOMINAL PAIN is mild and with no clear-
cut characteristics and with no CUES for a specific
disease whatsoever,
DIAGNOSIS is usually “Non-specific RLQ
abdominal pain”. [This has to be monitored
afterwards.]
Early stage of medical
condition or disease
or mild medical
condition in the
sources of pain
usually produces NO
distinct character or
nature. (Just mild
feeling of discomfort!)

34. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Clinical diagnosis of RLQ abdominal pain?
In patients with RLQ ABDOMINAL PAIN but
without clear-cut CUES for
• Abdominal mass
• Abdominal obstruction
and ABDOMINAL PAIN is mild and with no clear-
cut characteristics and with no CUES for a specific
disease whatsoever,
DIAGNOSIS is usually “Non-specific RLQ
abdominal pain”. [This has to be monitored
afterwards.]
At times, watchful
waiting may allow
more distinct
character or nature of
the unpleasant feeling
to show up, thereby
facilitating diagnosis.

35. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Clinical diagnosis of RLQ abdominal pain?
Onset and course of pain – aids in clinical
diagnosis
• Acute or recent - about a week or two
• Chronic – lasting for about 3 months
• Recurrent – 3 episodes within 3 months
• Progressive – increasing in intensity
Some abdominal
conditions and
diseases have typical
courses.
Some have chronic
and recurrent track
records – such as
dysmenorrhea and
colonic diverticulitis.
Others just one bout
or rarely recur.
Progressive connotes
serious diagnosis.

36. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Clinical diagnosis of RLQ abdominal pain?
Severity of pain – aids in clinical diagnosis
• Mild
• Moderate
• Severe (of greatest urgency)
Some abdominal
conditions and
diseases have typical
severity score.
Some are usually
mild. Some usually
moderate in pain.
Some usually severe.
Example: pain caused
by ureteral stones
causing acute
obstruction will have
severe pain.
SEVERE PAIN – aside from
implying greatest urgency in
medical treatment, it also has a
connotation in diagnosis and
subsequent treatment. Example:
ACUTE ABDOMEN

37. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Clinical diagnosis of RLQ abdominal pain?
ACUTE ABDOMEN is a condition, usually with
severe abdominal pain, that demands urgent
attention and treatment.
ACUTE SURGICAL ABDOMEN is a condition,
usually with severe abdominal pain, that
demands urgent attention and operative
treatment.
ACUTE NON-SURGICAL ABDOMEN is a condition
that demands urgent attention and non-operative
treatment.
Sometimes the
specific cause of the
acute abdomen
cannot be definitely
established.
It is enough for the
physician to decide
whether it is a
SURGICAL or NON-
SURGICAL abdomen.
This is a special
category of clinical
diagnosis of
abdominal pain.

38. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Paraclinical diagnostic procedures for RLQ
abdominal pain?

39. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Paraclinical diagnostic procedures for RLQ
abdominal pain?
Common instrumental and laboratory diagnostic
procedures for ABDOMINAL PAIN:
• Imaging procedures (x-rays – plain / with
barium dye; ultrasound; CT scan; MRI; PET
scan; etc.)
• Endoscopy (upper - esophagogastroscopy /
lower – colonoscopy, sigmoidoscopy,
proctoscopy)
• Blood tests (CBC; liver function tests; tumor
markers; etc.)

40. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Paraclinical diagnostic procedures for RLQ
abdominal pain?
The foremost indication for a paraclinical
diagnostic procedure can be stated this
way:
if you are not certain on the primary
clinical diagnosis and you need to be
certain or be more certain before
treatment, then go for a paraclinical
diagnostic procedure.

41. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Paraclinical diagnostic procedures for RLQ
abdominal pain?
To decide on indication of the paraclinical
diagnostic procedure,
the physician uses two processes –
- degree of certainty on the primary
clinical diagnosis and
- comparison of the treatment plans for
the primary and secondary clinical
diagnoses.
As a rule, there is no need
for a paraclinical
diagnostic procedure if:
• you are quite
certain of your
primary clinical
diagnosis.
• treatment plans for
primary and
secondary
diagnoses are the
same.

42. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Paraclinical diagnostic procedures for RLQ
abdominal pain?
Competencies required of physicians managing
abdominal pain:
• Know the uses and indications of all known
instrumental and laboratory diagnostic
procedures for abdominal pain.
• Use as needed and indicated.
• Select the most cost-effective one using the
BRCA process.
• Know how to interpret the results.

43. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Paraclinical diagnostic procedures for RLQ
abdominal pain?
BRCA Process in selecting diagnostic procedures
Procedures Benefit
(goal – to
be more
definite on
the
diagnosis)
Risk Cost Availability
Option1
Option2
Option3

44. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Clinical diagnosis of RLQ abdominal pain?
ACUTE ABDOMEN is a condition, usually with
severe abdominal pain, that demands urgent
attention and treatment.
ACUTE SURGICAL ABDOMEN is a condition,
usually with severe abdominal pain, that
demands urgent attention and operative
treatment.
ACUTE NON-SURGICAL ABDOMEN is a condition
that demands urgent attention and non-operative
treatment.
Sometimes the
specific cause of the
acute abdomen
cannot be definitely
established.
It is enough for the
physician to decide
whether it is a
SURGICAL or NON-
SURGICAL abdomen.
This is a special
category of clinical
diagnosis of
abdominal pain.

45. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Clinical diagnosis of RLQ abdominal pain?
ACUTE ABDOMEN is a condition, usually with
severe abdominal pain, that demands urgent
attention and treatment.
ACUTE SURGICAL ABDOMEN is a condition,
usually with severe abdominal pain, that
demands urgent attention and operative
treatment.
ACUTE NON-SURGICAL ABDOMEN is a condition
that demands urgent attention and non-operative
treatment.
Sometimes the
specific cause of the
acute abdomen
cannot be definitely
established.
It is enough for the
physician to decide
whether it is a
SURGICAL or NON-
SURGICAL abdomen.
This is a special
category of clinical
diagnosis of
abdominal pain.
In patients with ACUTE SURGICAL
ABDOMEN, NO TIME should be wasted on
paraclinical diagnostic procedures just to
establish the definite cause. A surgeon
should operate without establishing the
specific cause. The operation can serve as
the paraclinical diagnostic procedure as it
will establish the cause.

46. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Basic treatment modalities for RLQ abdominal
pain?

47. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
SPECIFIC DISEASE SURGICAL / POTENTIALLY SURGICAL / NON-SURGICAL
W
X
Y
Z
• Surgical – outright surgical
• Non-surgical – non-surgical at all times (no operation)
• Potentially surgical – surgical only when needed
• Basic treatment modalities for RLQ abdominal
pain?

48. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Surgical – outright surgical
• Non-surgical – non-surgical at all times (no operation)
• Potentially surgical – surgical only when needed
Examples of OUTRIGHT SURGICAL ABDOMEN
• Acute surgical abdomen
• Complete intestinal obstruction
• Peritonitis secondary to ruptured appendicitis
• Resectable tumors
• Basic treatment modalities for RLQ abdominal
pain?
Surgical Treatment:
• Drainage of
infections
(abscesses)
• Removal (-ectomy
such as
cholecystectomy)
• Repair (-rrhaphy
such as
enterorrhaphy)

49. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Surgical – outright surgical
• Non-surgical – non-surgical at all times (no operation)
• Potentially surgical – surgical only when needed
Examples of POTENTIALLY SURGICAL ABDOMEN
• Asymptomatic urinary bladder polyps
• Asymptomatic diverticulitis
• Incomplete intestinal obstruction
• Asymptomatic benign tumors
• Basic treatment modalities for RLQ abdominal
pain?

50. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Surgical – outright surgical
• Non-surgical – non-surgical at all times (no operation)
• Potentially surgical – surgical only when needed
Examples of OUTRIGHT NON-SURGICAL
ABDOMEN
• Urinary tract infection
• Primary dysmenorrhea
• Uncomplicated salpingitis
• Enterocolitis
• Basic treatment modalities for RLQ abdominal
pain?
Non-Surgical Treatment:
• Medicines
• NO medicines (watchful waiting;
natural support management; etc.)

51. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
BRCA Process in selecting cost-effective treatment
modality.
• Basic treatment modalities for RLQ abdominal
pain?

52. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Management of APPENDICITIS

53. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Management of APPENDICITIS
Appendicitis is a common medical disease
that all laypeople should be aware of it;
recognize it; know what to do; and be
knowledgeable of how physicians manage
it.
(A PATIENT EMPOWERMENT PROGRAM).

54. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Management of APPENDICITIS
In all patients with RLQ abdominal pain, without
history of appendix removal or operation,
appendicitis is always a possibility and should be
considered in the evaluation.
However, NOT all RLQ abdominal
pains are due to appendicitis.

55. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Management of APPENDICITIS
Acute appendicitis is an inflamed
appendix.

56. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Management of APPENDICITIS
Acute appendicitis is an inflamed appendix.
A blockage in the blind tubular appendix is the
likely cause of appendicitis.
Blockage may be caused by inflammation of lining
of appendix or hardened feces.
The bacteria multiply rapidly, causing the
appendix to become inflamed, swollen and filled
with pus.
If not treated promptly, the inflamed appendix
can rupture.

57. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Management of APPENDICITIS
Clinical Diagnosis of Acute Appendicitis
Presence of definite, persistent, progressive pain
and tenderness on the RLQ abdomen and in the
ABSENCE of symptoms of urinary and bowel
disturbance and obstetrical-gynecologic
conditions in female patients
In the presence of symptoms in the other organs
in the RLQ, such as urinary disturbance, think
twice before making a diagnosis of acute
appendicitis.

58. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Management of APPENDICITIS
Paraclinical Diagnostic Procedures for Acute
Appendicitis
Options:
• Close monitoring of RLQ pain and tenderness
and other associated symptoms (clinical
monitoring)
• Ultrasound
• CT scan
Most cost-effective is close monitoring.

59. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
• Management of APPENDICITIS
Treatment for Acute Appendicitis
Options:
• Operation to remove the appendix
• Antibiotics
Most cost-effective is operation.

60. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
Summary
Take Away
Contents of RLQ ABDOMINAL PAIN
and APPENDICITIS
• What is a RLQ abdominal pain?
• What are the different types of RLQ abdominal
pain?
• What are the causes of RLQ abdominal pain?
• How common are RLQ abdominal pain?
• Clinical diagnosis of RLQ abdominal pain?
• Paraclinical diagnostic procedures for RLQ
abdominal pain?
• Basic treatment modalities for RLQ abdominal
pain?
• Management of APPENDICITIS

61. Fundamentals
and Generalities
in Medical
Management of
RLQ ABDOMINAL
PAIN and
APPENDICITIS
Be always in touch with reliable medical
information on fundamentals and
generalities in medical management of
RLQ ABDOMINAL PAIN and APPENDICITIS.
Knowledge is power; it gives power.
Use the 4Ks of Patient Empowerment:
Kaalaman, Kakayanan, Karapatan and
Kapangyarihan
to gain greater control over decisions in
medical management of RLQ ABDOMINAL
PAIN and APPENDICITIS.
Take Away in
relation to
Patient
Empowerment

62. Empowerment
objective - for
laypeople to have an
understanding of
the FUNDAMENTALS
and GENERALITIES in
the MEDICAL
MANAGEMENT of
RLQ ABDOMINAL
PAIN and
APPENDICITIS.
Health Disorder
Course–
Fundamentals
and
Generalities in
Medical
Management
of RLQ
ABDOMINAL
PAIN and
APPENDICITIS
April 2, 2022
1400H - 1500H
Via Zoom
RLQ – Right Lower Quadrant