An 18-year-old boy presented with abdominal pain, vomiting, and painful urination, leading to a diagnosis of appendicitis confirmed by elevated WBC, CRP, and ultrasound indicating inflammation. Key physical signs included McBurney's point tenderness and a positive Rovsing's sign. Immediate surgery, likely through laparoscopic method, is recommended to remove the inflamed appendix to prevent complications such as peritonitis.

2. • A 18 years old boy came to the clinic with the complain
of abdominal pain.
• He had pain in Right Lower Quadrant and also had mild
tenderness.
• He had vomiting since 3-4 days and also complaint of
loss of appetite.
• He had also painful urination and difficulty for passing
urine.
• His temperature was about 102°F and pulse was 78.
• The blood pressure was 122/65 mmHg.

3. So, Guys What you are thinking now ???
• Diagnostic lists….
1. CBC
2. CRP
3. Urine Test
4. Ultrasound of Abdomen

4. • In his blood report WBC were elevated and there was fluctuation in
Lymphocytes.
• CRP was elevated to 6 (Normal value is 0-3).
• In Urine test , there was no showing of infections in Urinary Tract.
• In ultrasound , there was inflammation in the Appendix.
• Physician palpated on abdominal region and founded McBurney's
sign means right lower quadrant abdominal tenderness.
• Also , Rovsing's sign is postive that means there is pain in RLQ after
pressing LLQ.
• So , now we can say that it’s Appendicitis !!!

5. McBurney's Point
• McBurney's point the point over the right side of the abdomen that is
one-third of the distance from the anterior superior iliac spine to
the umbilicus /navel.
• It is most common location where the Appendix is present.
• It is only one physical finding or clinical menifestaion for finding
Appendicitis.

7. Overview
• Appendicitis is an inflammation of the appendix ,which is a finger-
shaped pouch that projects from colon on the lower right side of
abdomen.
• It can cause pain in lower right abdomen, however pain begins
around the navel and then moves.
• As it’s inflammation, pain typically increases and eventually becomes
severe.
• Often, it occurs in people between the ages of 10 and 30.

8. Symptoms
• Dull pain near the navel or the upper abdomen that becomes sharp
as it moves to the lower right abdomen.
• Loss of appetite
• Nausea
• Vomiting
• Abdominal swelling
• Fever
• Abdominal cramps

9. Causes
• Blockage of food or stool
• Bacterial infection
• Cancer

10. Complications
• If it is not treated inflamed appendix will eventually burst, or
perforate, spilling infectious materials into the abdominal cavity.
• This can lead to peritonitis, a serious inflammation of peritoneum.
• Sometimes a pus-filled abscess forms outside the inflamed appendix.
• An abscessed appendix can also cause peritonitis.
• So, in this condition we have make immediate surgery to remove the
appendix and clean abdominal cavity.

11. Diagnosis
• Physical examination
• Blood test to check WBC count
• CRP for Inflammation
• Urine test for checking urinary tract infection
• Imaging like Ultrasound, Abdominal X-ray, CT scan, MRI

12. Treatment
• Appendectomy - Surgical process to remove inflamed appendix.
• Laparoscopic surgery – Now a days it is more convenient and useful.
• Because recovery is faster than appendectomy and healing with less pain and
scarring.
• Before surgery patient may be given a dose of antibiotics to treat
infection.

13. Imaging