Acute inflammation of the vermiform appendix, typically from luminal obstruction.
Clinical features
- • Periumbilical pain migrating to RIF over 12–24 h
- • Anorexia, nausea, low-grade fever
Examination
- • RIF tenderness at McBurney's point
- • Rovsing, psoas, obturator signs
- • Guarding / rebound if perforated
Investigations
- • FBC (↑WCC, neutrophils), CRP
- • βHCG (exclude ectopic)
- • Urinalysis
- • USS in women/children, CT in adults if uncertain
- • Alvarado / AIR score
Management
- • IV fluids, analgesia, antiemetic
- • IV antibiotics (e.g. co-amoxiclav)
- • Laparoscopic appendicectomy (gold standard)
- • Non-operative antibiotics selected uncomplicated cases
Complications
- • Perforation, abscess
- • Peritonitis
- • Surgical: SSI, ileus, adhesions
Clinical pearls
- • Atypical presentations in elderly / pregnancy / retrocaecal
- • βHCG mandatory in women of reproductive age
Related in WardRound
Educational — verify locally.
