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16 Cards in this Set
- Front
- Back
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Opening of appendix into cecum guarded by which valve |
Valve of Geralch |
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Various positions of the appendix |
Retrocecal Preilial Postilial Subcecal Pelvic Subhepatic Paracecal |
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Worm that can cause appendicitis |
Oxyuris vermicularis |
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Pseudoappendicitis |
Appendicitis due to acute ileitis following Yersinia infections often due to Crohns disease |
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Clinical features of appendicitis |
Pain: first visceral starting around umbilicus due to distention of appendix few hours later somatic in RIF then if not treated diffuse Vomiting due to reflex pylorospasm Murphy's triad: Pain first vomiting second and fever last Constipation but sometimes diarrhoea Fever, tachycardia, Fetor oris Urinary frequency Tenderness, rebound tenderness at McBurney's point-Blumberg's sign Rovsing's sign Hyperextension of the right hip causes pain in RIF due to Psoas muscle-retrocecal(Cope's psoas test) Internal rotation of the hip causes pain due to obturator internus in pelvic appendix-Obturator test Baldwings test Mass on palpation Dumphy's cough tenderness |
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Differential diagnosis of Appendicitis |
Perforated peptic ulcer Ovarian mass Acute cholecystitis Rt ureteric colic Enterocolitis Rt acute pyelonephritis Mesenteric lymphadenitis Lobar pneumonia Crohns disease Acute pancreatitis Merckels diverticulum Salpingitis Diabetic abdomen Ruptured Ectopic Typhlitis
Typhlitis |
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Differential diagnosis in children |
Meckel's diverticulitis Acute colitis Intussusception Acute ilial lymphadenitis Roundworm colic Lobar pneumonia |
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Differentials in female |
Ruptured ectopic Salpingo oophoritis Mittelschmerz Ovarian cyst torsion |
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Differentials in the elderly |
Acute diverticulitis Carcinoma cecum Mesenteric ischemia Intestinal obstruction Aortic aneurysm Crohns disease |
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Incisions for surgery |
Gridiron Lanz crease Rutherford Morison muscle cutting Rt lower paramedian incision |
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Complications of appendicectomy |
Paralytic ileus Intestinal obstruction Reactionary hemorrhage Residual abscess Portal pyemia Rt inguinal hernia Wound sepsis Fecal fistulae DVT and respiratory problems |
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Appendicular mass |
Localisation of infection in the 3-5 day after an attack of acute appendicitis |
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Features of appendicular mass |
Does not move with respiration, located in RIF, Smooth, tender, regular edges, non mobile, firm, well localised, resonant on percussion |
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Differential diagnosis of appendicular mass |
Ovarian mass Carcinoma cecum Crohns disease Actinomycosis Ruptured ectopic Ileocecal TB Mesenteric lymphadenitis |
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Treatment for an appendicular mass |
Oschner-Sherren regimen: Monitoring of patient vitals Mark the mass to observe retrogression or progrsession Antibiotics IV fluids Analgesia NG tube aspiration initially |
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Management of appendicular abscess |
Start antibiotics CT guided drainage or catheter drainage Surgery to drain pus under general anesthesia and sent for culture and sensitivity Interval appendicectomy after 3 months Pelvic abscess drained per rectal or through posterior colpotomy |
