appendicitis

Symptoms of AA

1- periumbilical or epigastric pain

2- migration to right lower quadrant

3- anorexia , nausea , vomiting

Sign of AA

1- bump sign

2- tenderness at RLQ ( McBurbey point)

3- rebound tenderness

4- Rovsing sign

5- psoas sign

6- obturator sign

Rectocecal appendix pain

Flank pain

Investigation

1- WBCs

2- CRP

3- Urinalysis

4- pregnancy test

5- US

6- CT

DD

1- inflammatory bowel disease

2- hernia

3- abscess

4- volvulus

5- diverticulitis

6- ectopic pregnancy

7- ovarian torsion

8- renal colic

9- genitourinary infection

10- muscular hematoma or abscess

Treatment

1- surgury

2- control pain ( fentanyl 1 microg/kg /4hr - morphine 0.1 mg/kg )

3- antibiotics ( piperacillin/tazobactam 3.375g iv or ampicillin/sulbactam 3g iv )