Most common surgical emergency - highest incidence between 10-20 y/os
Causes/Factors
Gut organisms invade the appendix wall after lumen obstruction by lymphoid hyperplasia, faecolith or filarial worms
Symptoms
Classical presentation of:
- Periumbilical pain that moves to right iliac fossa
- Peritonism with guarding and rebound
- Anorexia is important - vomiting rarely before pain
Signs
- Tachycardia, fever
- Mcburney’s point - between umbilicus and right iliac fossa
- Rovsing’s sign - push on left iliac fossa and pain exhibits itself on right
Diagnostic Tests
- FBC, U&Es, WCC, CRP
- US/CT if unclear
Management
- Appendectomy
Conservative treatment with just antibiotics can be indicated in some cases
Complications/red Flags
- Perforation - big problem
- Appendix mass may result when inflamed appendix becomes covered with omentum
- Appendix abscess`