Appendicitis is an inflammation of the appendix, a blind-ended tube connected to the cecum. It requires urgent surgery to remove the appendix. Symptoms include abdominal pain that starts around the navel and moves lower right, nausea, vomiting, loss of appetite. A physical exam may reveal tenderness in the lower right abdomen. Blood tests typically show an elevated white blood cell count. A CT scan is the gold standard diagnostic test and can show an enlarged appendix with possible appendicoliths or wall thickening. Treatment involves urgent surgery to remove the appendix, either through an open or laparoscopic appendectomy.

1. Appendicitis
Presenter,
Jeevan kishore
Group no : 16

2. overview
o Inflammation
of the appendix
o Need urgent
surgery

3. ANATOMY
• Blind-ended tube connected to
the cecum
• Most appendices are 6 to 9 cm long
but can also vary in length from 5 cm
to 30 cm
• Location differs in different people.

5. o Age onset : 5 years to 40 years
o Mostly affected : males
o Lifestyle : Rural
o Diet : low fiber
Epidemiology

6. This mostly occurs due to
obstruction of the vermiform
appendix
causes
-Fecal material
-Foreign body
-Carcinoma of the cecum
-Stenosis-Inflammation
-Kinking of the organ
-Infections
pathophysiology

7. Symptoms &
signs

9. Physical exam
Rebound
tenderness at
McBurney's point
Blumberg
sign

10. Rovsing’s sign

11. Psoas sign – hip extension
Obturator sign – hip flexion
Dunphy sign

12. Lab test
Blood test
• Leukocytes more than
10,000/microL in 90% of patients
• C-reactive protein is elevated
• Neutrophils is elevated more than
75%
Urinalysis
Usually normal
but sometimes
leukocytes and
erythrocytes
and even
hematuria is
noted.

13. CT scanGold standard
diagnostic method.
On CT scan can be
seen :
• Enlarged
appendix.
• Appendicoliths.
• Intramural air
• Appendix wall
thickening.

14. Dilated cecum

15. DDX

16. Treatment
Urgent surgery should
be performed.
• Open appendectomy
• Laparoscopic
appendectomy

17. Prepare patient for surgery
• Antibiotics ( cephalosporins ) before
operating.
• General or spinal anesthesia.
• Clean area for operating.
• Operate ( open or laparoscopically )
• Incase if rupture – wash abdomen fully and
insert drainage tube.

20. • Harrisons principle of internal medicine.
• Davidson principle and practice of medicine.
• Current diagnostics and treatment in surgery 2018.
• Lange current medical diagnosis and treatment.
• Current surgical procedures.
• https://www.medifee.com/blog/is-appendix-the-
hidden-reason-behind-stomach-ache/
• https://emergencyus.wikispaces.com/Appendicitis
• Images from google, books and other sites.
References