APPENDICITIS- introduction, definitions, etiology, pathophysiology, clinical manifestations, diagnosis and management.

1. APPENDICITIS
By
Y.V Vanaja
Lecturer
Vijay Marie College of Nursing

2. Introduction
• The appendix is a small, finger-like appendage attached to the cecum
just below the ileo-cecal valve.
• Because it empties into the colon inefficiently and its lumen is small, it
is prone to becoming obstructed and is vulnerable to infection.
• The obstructed appendix becomes inflamed and edematous and
eventually fills with pus, this is called appendicitis

3. Definition
 Appendicitis is an acute Inflammation of the vermiform appendix.
Inflammation occurs when the lumen of the appendix is obstructed,
leading to infection as bacteria invade the wall of the appendix
“ “Ignatavivcious”
• Appendicitis is an inflammation of the appendix, a narrow blind tube
that extends from the interior part of the cecum. “Lewis”
• the appendix becomes inflamed and edematous as a result of either
kinked or occluded by a fecalith, tumor or foreign body
“Brunner”

4. INCIDENCE
• Males are affected more than females.
• Teenagers more frequently than adults.
• The highest incidence is in those between the ages
of 10 and 30years

5. Types of appendicitis

10.  Lumen of the appendix is obstructed as a result of fecaliths
 Less common causes are – malignant tumors
 Trauma to the abdomen
 Intramural thickening caused by hyper
growth of lymphoid tissue
 Venous engorgement
 Accumulation of mucus and bacteria

11. Pathophysiology
Obstruction can result from food matter, adhesion, or lymphoid hyperplasia
Mucosa continues to secrete fluid.
Increase in the intraluminal pressure and restricting the blood flow.
End result is perforation and spillage of infected appendiceal contents into the
peritoneum
as inflammation continues, serosa and adjacent structures become inflammed

12.  Resulting in the generalized or upper abdominal pain that becomes localized in the
RLQ
 eventually the inflamed appendix fills with pus
 If rapid process may result in peritonitis

13. Clinical manifestation

17. Painful urination
Severe cramps
Dunphy’s sign (increased pain with
coughing).
Obturator sign( pain on internal
rotation of right thigh)
Psoas sign (pain on extension of right
thigh).

18. Complications
 Perforation
 Peritonitis
 Abscess

24. Diagnostic evaluation
• Complete physical examination.
• Abdominal x-ray.
• Ultrasound
• Complete blood count
• CT scan
• Rectal exam
• Urine test

27. • Antibiotics
• NPO
• Iv fluid
• Analgesics
• Antiemetics
Medical
managemen

28. Surgical management
 laparoscopic Appendectomy
 A new procedure is known as Natural orifice transluminal endoscopic
surgery , does not require an external skin incision

30.  Laparotomy is an open surgical approach with a larger abdominal incision for complicated or
atypical appendicitis or peritonitis