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1. APPENDICITIS
Ms.Beena Vaza

2. INTRODUCTION
• The appendix sits at the junction of the small intestine
and large intestine.
• It’s a thin tube about four inches long. Normally, the
appendix sits in the lower right abdomen.
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3. DEFINITION
•Appendicitis is an inflammation of the
vermiform appendix that develops most
commonly in adolescents and young
adults.
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4. ETIOLOGY
OBSTRUCTIVE CAUSES :
• Fecal calculus or stone that occlude lumen of the appendix.
• Twisting or curling of the appendix.
• Swelling of the bowel wall
NON ONSTRUCTIVE CAUSES :
• Spread of infection
• Vascular occlusion
• Trauma
• Diet lacking fibres
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5. PATHOPHYSIOLOGY
Due to etiological factors
Obstruction of appendix due to fecalith tumor
Increased intraluminal pressure
Ischemic injury
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6. CONT…
Bacterial proliferation (Tissue becomes infected by
bacterial in the digestive tract)
Puss accumulation
Appendicitis
Rupture appendix
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7. SIGN & SYMPTOMS
• Lower abdominal pain
• Vomiting
• Anorexia
• Fever
• Haematuria (Uncommon)
• Constipation
• Abdominal rigidity
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8. DIAGNOSTIC EVALUATION
• History collection
• Physical examination
• Blood tests
- Elevated WBC count
- Elevated C reactive protein
• Urinanalysis
• X- ray
• Abdominal USG
• CT scan
• MRI
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9. MEDICAL MANAGEMENT
• To treat infection
• Give antibiotics for bacterial infection
• Give analgesics for pain
• Give antipyretics for fever
• Give antiemetics for vomiting
• Give fluid therapy for electrolyte balance
• Give supportive drugs for nutritional support
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10. SURGICAL MANAGEMENT
• The surgical procedure for the removal of the appendix is
called an appendectomy.
• Appendectomy can be performed through open or
laparoscopic surgery.
• Laparoscopic appendectomy has several advantages over
open appendectomy as an intervention for appendicitis.
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11. PRE – OPERATIVE
PREPARATION
• Once diagnosis is suspected , the patient is admitted to
hospital
• Give IV fluid ( NS or RL)
• Ryle’s tube is not necessary in simple appendicitis.
• Second generation cephalosporin along with metronidazole is
given.
• Informed consent is taken.
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12. APPENDECTOMY
• It is a surgical procedure to remove the appendix from the
abdomen.
• It can be performed either with a small incision on the
abdomen or laparoscopically ( key hole surgery).
INDICATIONS FOR OPEN APPENDECTOMY :
• Severe inflammation or prior surgical procedures.
• Perforated or gangrenous appendicitis.
• peritonitis.
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13. LAPAROSCOPIC APPENDECTOMY
• Become popular nowdays.
• Less post operative pain.
• Speedy recovery.
• If intraoperative complication that cannot be handled with
laparoscopy arise during laparoscopic appendectomy,
conversion to an open appendectomy.
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14. NURSING MANAGEMENT
NURSES RESPONSIBILITY
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