About

The appendix becomes inflamed due to infection trapped in the appendix by obstruction at the point where the appendix meets the bowel.

The inflammation can quickly proceed to gangrene and rupture. The appendix can rupture and release faecal content and infective material into the abdomen. This leads to peritonitis.

Peak Incidence = 10 - 20 years

PC:

Key feature - abdominal pain, typically starts at the umbilical region, and then localises to RIF. This should be acute, less then 12-24 hours

Other symptoms (could accompany appendicitis but don't have to):

• Fevers, chills
• Nausea/vomitting
• Anorexia
• Dysuria
• Diarrhoea (rare)

Appendicitis may present with confusion in the elderly and minimal abdominal symptoms

Physical exam:

• Tenderness in McBurney's point (RLQ) + rebound tenderness + guarding (involuntary more likely to be found when its burst)
• Rovsing's sign
• Obturator sign (bend knee) and Psoas sign (extend hip) not very specific
• Right sided tenderness on PR exam