CONTENT

NO ITEM PAGE

1. CONTENT PAGE

2. INTRODUCTION

3. ETIOLOGY

4. SIGN & SYMPTOM

5. INVESTIGATION

6. DIFFERENTIAL DIAGNOSIS

7. COMPLICATIONS

8. MANAGEMENT

9. SUMMARY

1
INTRODUCTION

Appendicitis is an inflammation of the appendix, a finger-shaped pouch that projects from your
colon on the lower right side of your abdomen. Appendicitis causes pain in your lower right
abdomen. However, in most people, pain begins around the navel and then moves. As inflammation
worsens, appendicitis pain typically increases and eventually becomes severe. Although anyone can
develop appendicitis, most often it occurs in people between the ages of 10 and 30. Standard
treatment is surgical removal of the appendix.

2
ETIOLOGY
A blockage in the lining of the appendix that results in infection is the likely cause of appendicitis.
The bacteria multiply rapidly, causing the appendix to become inflamed, swollen and filled with pus.
If not treated promptly, the appendix can rupture.

In many cases, the exact cause of appendicitis is unknown. Experts believe it develops when part of
the appendix becomes obstructed, or blocked.

Many things can potentially block your appendix, including:

 a buildup of hardened stool

 enlarged lymphoid follicles

 intestinal worms

 traumatic injury

 tumors

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SIGN & SYMPTOM

 pain in your upper abdomen or around your bellybutton

 pain in the lower right side of your abdomen

 loss of appetite

 indigestion

 nausea

 vomiting

 diarrhea

 constipation

 abdominal swelling

 inability to pass gas

 low-grade fever

Appendicitis pain may start off as mild cramping. It often becomes more steady and severe over
time. It may start in your upper abdomen or bellybutton area, before moving to the lower right
quadrant of your abdomen.

If you’re constipated and you suspect that you may have appendicitis, avoid taking laxatives or using
an enema.

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INVESTIGATION

Complete blood count

To check for signs of infection, your doctor may order a complete blood count (CBC). To conduct
this test, they will collect a sample of your blood and send it to a lab for analysis. Appendicitis is
often accompanied by bacterial infection. An infection in your urinary tract or other abdominal
organs may also cause symptoms similar to those of appendicitis.

Urine tests

To rule out urinary tract infection or kidney stones as a potential cause of your symptoms, your
doctor may use urinalysis. This is also known as a urine test.

Pelvic exam

If you’re female, your symptoms might be caused by pelvic inflammatory disease, an ovarian cyst, or
another condition affecting your reproductive organs. To examine your reproductive organs, your
doctor may perform a pelvic exam. During this exam, they will visually inspect your vagina, vulva,
and cervix. They will also manually inspect your uterus and ovaries. They may collect a sample of
tissue for testing.

Abdominal imaging tests

To check for inflammation of your appendix, your doctor might order imaging tests of your
abdomen. This can also help them identify other potential causes of your symptoms, such as
an abdominal abscess or fecal impaction. Your doctor may order one or more of the following
imaging tests:

 abdominal ultrasound

 abdominal X-ray

 abdominal CT scan

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DIFFERENTFIAL DIAGNOSIS

 Gallbladder problems – includes inflammation, infection, stones or blockage of the gallbladder.

 Gastritis
 Urinary tract infection
 Crohn’s disease
 Intestinal infection
 Kidney stone

COMPLICATIONS
 A ruptured appendix
o A rupture spreads infection throughout your abdomen and become peritonitis. Possibly
life threatening, this condition requires immediate surgery to remove the appendix and
clean your abdomen cavity.
 A pocket of pus that forms in the abdomen.
o If your appendix bursts, you may develop a pocket of infection or called as abscess. In
most cases, a surgeon drains the abscess by placing a tube through your abdominal wall
into the abscess. The tube is left in place for two weeks, and you’re given antibiotics to
clear the infection.

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MANAGEMENT
Surgery to remove the appendix (appendectomy)

Appendectomy can be performed as open surgery using one abdominal incision about 2 to 4 inches
(5 to 10 centimeters) long (laparotomy). Or the surgery can be done through a few small abdominal
incisions (laparoscopic surgery). During a laparoscopic appendectomy, the surgeon inserts special
surgical tools and a video camera into your abdomen to remove your appendix.

In general, laparoscopic surgery allows you to recover faster and heal with less pain and scarring. It
may be better for older adults and people with obesity.

But laparoscopic surgery isn't appropriate for everyone. If your appendix has ruptured and infection
has spread beyond the appendix or you have an abscess, you may need an open appendectomy,
which allows your surgeon to clean the abdominal cavity.

Expect to spend one or two days in the hospital after your appendectomy.

Draining an abscess before appendix surgery

If your appendix has burst and an abscess has formed around it, the abscess may be drained by
placing a tube through your skin into the abscess. Appendectomy can be performed several weeks
later after controlling the infection

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SUMMARY

DEFINITION • an inflammation of the appendix

• a buildup of hardened stool

• enlarged lymphoid follicles
ETIOLOGY • traumatic injury
• tumors

•pain
•indigestion
S&S •loss appetite
•nausea

•blood test
•urine test
INVESTIGATION •pelvic exams
•abdominal imaging test

DIFFERENTIAL •Gastritis
•Urinary tract infection
DIAGNOSIS •Crohn’s disease

•A ruptured appendix
COMPLICATION •A pocket of pus that forms in the abdomen.

•Surgery to remove the appendix (appendectomy)

MANAGEMENT •Draining an abscess before appendix surgery