Acute Appendicitis Overview

Acute Appendicitis

• Pain in the lower right abdomen is a hallmark symptom, often starting as generalized or upper abdominal pain before intensifying and localizing.
• Pain is typically aggravated by movement, walking, and coughing.
• Tenderness at McBurney point (between the umbilicus and anterior superior iliac spine) is a characteristic finding.
• Rebound tenderness (relief of pain with direct palpation, followed by pain on release of pressure) is often present.
• Other symptoms may include low-grade fever, loss of appetite, nausea, and vomiting.
• Older adults may experience less acute pain and local tenderness, leading to delayed diagnosis.
• Appendicitis can progress more rapidly in older adults, increasing the risk of complications and higher mortality rates.
• Pregnancy can cause a shift in the location of pain due to uterine displacement.
• In adolescent and young women, symptoms must be differentiated from conditions like mittelschmerz (ovulation pain), ruptured ectopic pregnancy, and pelvic inflammatory disease.

Complications of Acute Appendicitis

• Perforation: A serious complication characterized by increased pain and high fever, potentially leading to:
  • Localized abscess formation
  • Local peritonitis
  • Generalized peritonitis

Chronic Appendicitis

• Characterized by recurrent episodes of chronic abdominal pain, typically occurring at intervals of several months or more.
• Differentiation from other conditions like inflammatory bowel disease (IBD) and renal issues is crucial.

Treatment of Appendicitis

• Acute Appendicitis:
  • Pain management with analgesics
  • Antibiotics
  • Surgery (appendectomy) to remove the inflamed appendix
• Peritonitis:
  • Removal of the ruptured appendix
  • Pain management
  • Antibiotics
  • Fluid resuscitation
  • Supportive treatment to maintain vital signs
• Chronic Appendicitis:
  • Appendectomy
  • Pain management
  • Antibiotics

This quiz focuses on the key symptoms and characteristics of acute appendicitis, including pain localization and physical examination findings. It also addresses variations in presentation among different populations, such as older adults and pregnant women, emphasizing the importance of accurate diagnosis. Test your knowledge of this common surgical emergency!