1/ #tweetorial
💠 When an Appendicitis Doesn’t Follow the Rules
➡️ Acute appendicitis is the most common abdominal emergency.
-- Read More: manualofmedicine.com/topics/gastroe…
#medtwitter #meded #foamed
💠 When an Appendicitis Doesn’t Follow the Rules
➡️ Acute appendicitis is the most common abdominal emergency.
-- Read More: manualofmedicine.com/topics/gastroe…
#medtwitter #meded #foamed
2/
➡️ It occurs when there is obstruction of the appendiceal lumen, from a:
👉 fecalith
👉 tumor
👉 infection
👉 hyperplasia of lymphoid follicles
➡️ It occurs when there is obstruction of the appendiceal lumen, from a:
👉 fecalith
👉 tumor
👉 infection
👉 hyperplasia of lymphoid follicles
3/
➡️ Classic symptoms include pain that is initially vague and periumbilical followed by a more localized parietal pain in the right lower quadrant.
➡️ Only 50% of people present with these classic symptoms; in the other 50%, appendicitis can be difficult to diagnosis.
➡️ Classic symptoms include pain that is initially vague and periumbilical followed by a more localized parietal pain in the right lower quadrant.
➡️ Only 50% of people present with these classic symptoms; in the other 50%, appendicitis can be difficult to diagnosis.
4/
➡️ Patients with congenital abnormalities (midgut malrotation or situs inversus totalis) may present with left-sided abdominal pain.
➡️ Retrocecal appendicitis may cause right upper quadrant pain. Retrocecal appendices are found in 26% to 65% of the population.
➡️ Patients with congenital abnormalities (midgut malrotation or situs inversus totalis) may present with left-sided abdominal pain.
➡️ Retrocecal appendicitis may cause right upper quadrant pain. Retrocecal appendices are found in 26% to 65% of the population.
5/
➡️ Rarely, patients with acute appendicitis may present with chest pain or epigastric pain.
➡️ Patients with undiagnosed congenital diaphragmatic hernia may have an inflamed appendix in the chest cavity, which would present as chest pain.
➡️ Rarely, patients with acute appendicitis may present with chest pain or epigastric pain.
➡️ Patients with undiagnosed congenital diaphragmatic hernia may have an inflamed appendix in the chest cavity, which would present as chest pain.
6/
➡️ There are three specific patient populations who are more likely to present with atypical pain from appendicitis:
👉 pregnant women
👉 children <5 years of age
👉 elderly patients
➡️ There are three specific patient populations who are more likely to present with atypical pain from appendicitis:
👉 pregnant women
👉 children <5 years of age
👉 elderly patients
7/
➡️ Acute Appendicitis in Pregnant Women
👉 If patients are in the third trimester, the appendix is located higher up in the abdomen, and patients may complain of right flank or right upper quadrant pain.
➡️ Acute Appendicitis in Pregnant Women
👉 If patients are in the third trimester, the appendix is located higher up in the abdomen, and patients may complain of right flank or right upper quadrant pain.
8/
➡️ Acute Appendicitis in Young Children
👉 Infants may have only lethargy and abdominal distention, while toddlers usually present with vomiting and diarrhea, which may be attributed to a viral syndrome.
➡️ Acute Appendicitis in Young Children
👉 Infants may have only lethargy and abdominal distention, while toddlers usually present with vomiting and diarrhea, which may be attributed to a viral syndrome.
9/
➡️Elderly patients may have vague or generalized abdominal pain.They also present to the ED later in the disease course, leading to higher rates of perforation
➡️Studies indicate that the majority of elderly with acute appy will have already perforated by the time of surgery
➡️Elderly patients may have vague or generalized abdominal pain.They also present to the ED later in the disease course, leading to higher rates of perforation
➡️Studies indicate that the majority of elderly with acute appy will have already perforated by the time of surgery
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