Appendicitis

//Western Diagnosis// acute inflammation of the appendix

Incidence
1. most common cause for an attack of acute abd pain and surgery in US 2. 15% of surgeries for this lead to other findings

Signs & Symptoms
1. typical sxs and sns in less than 50% of pts. with this 2. sudden onset of epigastric or peri-umbilical pain 3. N, V 4. RLQ pain after a few hours 5. RLQ tenderness and rebound tenderness 6. localized pain on cough 7. dec bowel movements 8. low-grade fever of 100o 9. mild leukocytosis 10. tenderness at McBurney’s point: 1/3 of the way from right ASIS to umbilicus 11. Rovsing’s sign: pain in RLQ from palpation of LLQ 12. psoas sign: increased pain from passive extension of R hip 13. adductor pain: passive internal rotation of flexed thigh 14. pain on rectal exam 15. many variations ---non-localized pain ---absent or diffuse tenderness even with pain, fever, leukocytosis

Diagnosis
1. clinical 2. leukocytosis 3. x-ray, ultrasound, CT scan of little use in early stages 4. in late stages, ultrasound and CT scan can help

Treatment
1. perforation can occur less than 24 hours after onset of sx 2. if suspected clinically, rapid surgery to avoid perforation and peritonitis 3. refer to ER if suspected

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Dietary Recommendations
Patient should fast and eat no solid food. Drink orange-blossom water, biocarbonated water and water sweetened w/ honey.