# appendicitis --- **appendicitis** >[!bug] Note incomplete >Hi! Chromatic here. If you've come to this note or section and it's disappointingly empty or unreadably messy, sorry! This is a placeholder note and/or my "raw" class notes. Technically every note in this vault is a work in progress, but I'm aware that this one is particularly rough. Hopefully I'll get to it one day. • Appendix- vermiform (wormlike) appendage about 8 to 10 cm attached to cecum • Inefficiently emptying of digestive fluids into cecum-prone to infection • Most common cause of emergency abdominal surgery in US especially ages 10-30. • Slightly higher in males, familial • Pathophysiology- Infected appendix, inflammation to area, once obstructed, becomes ischemic • Clinical Manifestation • Vague periumbilical pain- visceral pain-dull & poorly localized....progresses to RLQ parietal pain-sharp, discrete, well localized • Nausea in 50% of pts • Low grade fever • Tender at McBurney point with pressure • Rebound tenderness (increased pain with release of deep palpation) • LLQ that paradoxical causes RLQ pain ## Ruptured Appendix Ruptured appendix- see peritonitis-painful, rigid abd • May have a temporary *relief of pain* at time of rupture very sus, and only short lasting • Constant pain with distension from paralytic ileus • Do not give laxative if pt has fever, nausea or abdominal pain we don't want to get that fecal matter to leak out ' Assessment and Diagnostic Findings • Abd CT scan-RLQ density or localized distention • Diagnostic laparoscopy ## Risk Factors Runs in families, slightly higher occurrence in men. ## Signs & Symptoms ## Diagnostic Tests ## Treatment • Surgical Management • Immediate surgery- Appendectomy-especially if gangrene appendix, perforation • Laparoscopy or laparotomy • Post operative probably on a [[surgical drain]] • 5 days antibiotics • IVF Pain management & pulmonary toileting • High Fowler's Bowel tones Progressive diet- NPO, then clear liquids, etc... ___