التهاب الزائدة

Definition

Appendicitis is blockage of the appendix, usually by a faecolith or lymphoid swelling, followed by inflammation; it can rupture.

Symptoms

• Pain starting around the navel then moving to the lower right abdomen
• Loss of appetite, nausea and vomiting
• Low-grade fever

Examination

• Tenderness at McBurney’s point
• Rebound tenderness
• Rovsing’s sign: pressing on the left hurts on the right

Diagnosis

Blood tests (raised white cells), ultrasound especially in children and pregnancy, and CT in adults.

Treatment

Surgical removal, usually laparoscopic, with antibiotics.

Pre-op nursing care

• Nil by mouth, IV fluids, analgesia
• No heat packs, laxatives or enemas

Sign of rupture

Pain suddenly disappears then returns worse with fever and a rigid abdomen: peritonitis.

Exam point

In children, the elderly and pregnancy, symptoms are often atypical, so rupture before diagnosis is more likely.