Appendicular abscess physical examination: Difference between revisions

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==Overview==
==Overview==


==Physical Examination==
==Laboratory findings==
Physical examinations mostly focus on abdominal findings. The patient may appear in pain with a [[fever]] and mild [[tachycardia]]. Even minimal pressure on the [[abdomen]] can elicit a marked response from the patient due to pain.
Lab findings that are not specific but include [[leukocytosis]] with a shift to the left along with elevation of [[ESR]] and [[CRP]]


===Vitals===
*[[Fever]]
*[[Tachycardia]]
*[[Hypotension]]  if the abscess is ruptured and associated with hemorrhage.
*[[Tachypnea]].<ref>Hardin, M. Acute Appendicitis: Review and Update. ''Am Fam Physician".1999, Nov 1;60(7):2027-2034</ref>
===Skin===
*[[Diaphoresis]]
*[[Pallor]]
*[[Cool extremities|Cold extremities.]]
===Abdomen===
* The abdominal wall is very sensitive to mild palpation.
* [[Rebound tenderness]] (it cannot be  elicited in most of the patients due to abscess formation)
* [[Abdominal guarding]]
* [[Rovsing's sign]] Deep palpation of the [[Iliac fossa|left iliac fossa]] may cause pain in the [[right iliac fossa]].
* [[Psoas sign ]] Occasionally, an inflamed appendix lies on the [[psoas]] muscle and the patient will lie with the right hip flexed for pain relief.
*[[Obturator sign]]<ref>{{Citation
| last1  = Stockman III
| first1 = James A.
| lastauthoramp = yes
| title    = Year Book of Pediatrics 2012
| publisher = Mosby
| place    = Maryland Heights, MO
| edition = 2012
| year    = 2012
}}</ref> If an inflamed [[appendix]] is in contact with the [[obturator internus]], spasm of the muscle can be demonstrated by flexing and internally rotating the hip.This maneuver will cause pain in the [[hypogastrium]].
* A [[digital rectal examination]] elicits tenderness in the [[rectovesical pouch]] in special cases of appendicitis.<ref name="wiki1"> Appendicitis. Wikipedia (2016). https://en.wikipedia.org/wiki/Appendicitis Accessed on March 14th, 2016</ref>
*In case of a [[Appendix|retrocaecal appendix]] even deep pressure in the right lower quadrant may fail to elicit tenderness.
==References==
==References==
{{Reflist|2}}

Revision as of 17:54, 2 March 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

Overview

Laboratory findings

Lab findings that are not specific but include leukocytosis with a shift to the left along with elevation of ESR and CRP

References