Symptoms of appendicitis which mean the complaining of the patient or what patient feel he feel first diffuse abdominal pain start around the umbilicus then become localized in the right iliaic fossa this the typical symptoms also patient suffer from nausea and anorexia which is very important symptoms in case of appendicitis u can also say no appendicitis without anorexia there is mild fever in the beginning also may associated with vomiting especially in obstructive type of appendicitis sometimes patient complain from diarrhea this symptoms must take you to pelvic appendicitis because the appendix make irritation to the rectum give feeling of diarrhea don not forget this also when feeling tensmus u must think in associated pelvic abscess low grade fever unless it is complicated become high fever sometimes patient feel pain in the right hypochondrium mimic acute
chocystitis as subhepatic appendicitis all these point should be in your mind with every case with acute abdominal pain
signs of appendicitis most important sign positive mcburnny tenderness(rebound tenderness) mean tender in the right iliac fossa and pain increase after removal of your hand because in case of renal colic the pain decrease after removal your hand also there is positive Rovsing sign mean when you press by you hand on the left iliac fossa the patient felt pain transfer to the right iliac fossa that is because the gas in the intestine push to other side increasing the pain not present in all cases
complication of appendicitis the most common causes of these complications are delayed diagnosis which can lead to 1-perforation which either become localized leading to appendicular abscess or generalized and causes peritonitis which it is fatal due to spread of infection in the whole abdominal cavity also other complication are appendicular mass due to delayed diagnosis other rare complication are gangernous at the base of appendix which may extend to the cecum causes perforation in the cecal wall which is catastroph complication which may end from just simple appendictomy to right hemicolectomy so dont say i can do appendictomy untill u can do right hemicolectomy because you can supervise by anything when u do appendictomy investigation in case of appendicitis 1- full blood picture we look to white blood cells(4.000-10.000 )which it is increase above normal it is sensitive and not specific test because other causes of inflammation can raise it like tonsillitis 2- urine analysis to show there is urine infection or red blood cells or no 3- abdominal sonar which can give as idea about the appendix which appear tube like structure and also showing there is appendicular mass or abscess or peritoneal collection also important in case of female patient because there may be ruptuerd ovarion cyst or ectopic pregnancy which mimic picture of acute appendicitis all must be in mind 4- CT abdomen
tags:features,appendicitis,clinical
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