Appendicitis resident survival guide: Difference between revisions

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(Created page with "__NOTOC__ {{CMG}} ==Definition== ==Causes== ===Life Threatening Causes=== ===Common Causes=== ==Management== ===Diagnostic Approach=== Shown below is an algorithm depi...")
 
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===Diagnostic Approach===
===Diagnostic Approach===
Shown below is an algorithm depicting the therapeutic approach to [[appendicitis]]  
Shown below is an algorithm depicting the therapeutic approach to [[appendicitis]]


{{Family tree/start}}
{{familytree  | | | | | | | | A01 | | | | | |A01=<div style="float: left; text-align: left; height: 20em; width: 30em; padding:1em;">  '''Characterize the symptoms'''  <br>
❑ Typical symptoms<ref> name="pmid11343547">{{cite journal| author=Lee SL, Walsh AJ, Ho HS| title=Computed tomography and ultrasonography do not improve and may delay the diagnosis and treatment of acute appendicitis. | journal=Arch Surg | year= 2001 | volume= 136 | issue= 5 | pages= 556-62 | pmid=11343547 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11343547  }} </ref> <br>
:♦ [[Abdominal pain]]([[right anterior iliac fosa]]) <br>
:♦ [[Anorexia]] <br>
:♦ [[Nausea and vomiting]]  <br>
❑ Atypical symptoms (common at extremes of age) <br>
:♦ [[Indigestion]] <br>
:♦ [[Flatulence]] <br>
:♦ [[Intestine|Bowel irregularity]] <br>
:♦ [[Diarrhoea]] <br>
:♦ [[Malaise|General malaise]] </div>}}
{{familytree  | | | | | | | | |!| | | | | | | }}
{{familytree  | | | | | | | | A02 | | | | | | A02=<div style="float: left; text-align: left; height: 25em; width: 30em; padding:1em;">  '''Examine the patient''' <br>
❑ Vitals<br>
:♦ [[Temperature]]: low grade [[fever]] of 101.0 Fº (higher [[fever]] as [[inflammation]] progreses) <br>
:♦ [[Heart rate]]: [[Tachycardia]] associated to [[fever]]  <br>
❑Abdomen<br>
:♦ [[Mc Burneys's point]] [[tenderness]] <br>
:♦ [[Rovsing sing]] <br>
:♦ [[Psoas sign| The psoas sign]] is related to retrocecal appendix <ref> name="pmid9880421">{{cite journal| author=Andersson RE, Hugander AP, Ghazi SH, Ravn H, Offenbartl SK, Nyström PO et al.| title=Diagnostic value of disease history, clinical presentation, and inflammatory parameters of appendicitis. | journal=World J Surg | year= 1999 | volume= 23 | issue= 2 | pages= 133-40 | pmid=9880421 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9880421  }} </ref>  <br>
:♦ [[Obturador sing]] <br>
❑ Skin <br>
:♦ [[Diaphoresis]] may be present
:♦ [[Pallor]] </div>}}
{{familytree  | | | | | | | | |!| | | | | | | }}
{{familytree  | | | | | | | | E02 | | | | | | E02= <div style="float: left; text-align: left; height: 10em; width: 30em; padding:1em;"> '''Order labs''' <br>
❑ [[Complete blood count]]: [[leukocytosis]] <br>
❑ [[Electrolytes]] <br>
❑ [[Urea]] </div>}}
{{familytree  | | | | | | | | |!| | | | | | | }}
{{familytree  | | | | | | | | F01 | | | | | | F01=<div style="float: left; text-align: left; height: 20em; width: 30em; padding:1em;"> '''Differential diagnosis'''<br>
❑ [[Intestinal obstruction]] <br>
❑ [[Acute cholecystitis]] <br>
❑ [[Perforated peptic ulcer]] <br>
❑ [[Mesenteric adenitis]] <br>
❑ [[Right ureteric infection]] <br>
❑ [[Urinary tract infection]] <br>
❑ [[Ectopic pregnancy]] <br>
❑ [[Torted ovarian cyst]]  </div> }}
{{familytree  | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |}}
{{Family tree/end}}


===Therapeutic Approach===
===Therapeutic Approach===

Revision as of 16:53, 19 February 2014

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Definition

Causes

Life Threatening Causes

Common Causes

Management

Diagnostic Approach

Shown below is an algorithm depicting the therapeutic approach to appendicitis


 
 
 
 
 
 
 
Characterize the symptoms

❑ Typical symptoms[1]

♦ Abdominal pain(right anterior iliac fosa)
♦ Anorexia
♦ Nausea and vomiting

❑ Atypical symptoms (common at extremes of age)

♦ Indigestion
♦ Flatulence
♦ Bowel irregularity
♦ Diarrhoea
♦ General malaise
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Examine the patient

❑ Vitals

♦ Temperature: low grade fever of 101.0 Fº (higher fever as inflammation progreses)
♦ Heart rate: Tachycardia associated to fever

❑Abdomen

♦ Mc Burneys's point tenderness
♦ Rovsing sing
♦ The psoas sign is related to retrocecal appendix [2]
♦ Obturador sing

❑ Skin

♦ Diaphoresis may be present
♦ Pallor
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Therapeutic Approach

Do´s

Don´ts

References

  1. ↑ name="pmid11343547">Lee SL, Walsh AJ, Ho HS (2001). "Computed tomography and ultrasonography do not improve and may delay the diagnosis and treatment of acute appendicitis". Arch Surg. 136 (5): 556–62. PMID 11343547.
  2. ↑ name="pmid9880421">Andersson RE, Hugander AP, Ghazi SH, Ravn H, Offenbartl SK, Nyström PO; et al. (1999). "Diagnostic value of disease history, clinical presentation, and inflammatory parameters of appendicitis". World J Surg. 23 (2): 133–40. PMID 9880421.
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