Appendicitis in Hindi- cause, sign, symptoms, investigation, treatment ||Learn with Dr. Shipra||

appendix ka dard appendix ki sujan Inflammation of appendix #appendix #lntestine #Appendicitis Appendicitis cause, appendix pain symptoms, appendicitis sign, appendix pain, appendicitis treatment, appendicitis diagnosis

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Position of Appendix-
It's a thin tube about four inches long. Shape of appendix- Vermiform shape
Normally, the appendix sits in the lower right abdomen (Rt. Iliac region).
Most common- Retrocecal
2nd most common- Pelvic

Appendicitis is an inflammation of the appendix.
It is a finger-shaped pouch that projects from your colon on the lower right side of your abdomen.
 Appendicitis causes pain in your lower right abdomen.

Etiology

More common in young man, white races, less fiber diet.
Family history
Obstruction of the appendiceal lumen typically by lymphoid hyperplasia but occasionally by a fecalith, foreign body, or even worms.
The obstruction leads to distention, bacterial overgrowth (appendix to become inflamed, swollen and filled with pus), ischemia & rupture.

Signs and symptoms of appendicitis- (PVT-murphys triad)

Sudden pain that begins around umbilicus (due to distension of appendix) and after few hour shifts to right iliac fossa.
Pain that worsens if you cough, walk or make other movements
Nausea and vomiting
Loss of appetite
Low-grade fever that may worsen as the illness progresses
Urinary frequency
Constipation or diarrhea( if appendix is in postileal or pelvic position)

Important signs in appendicitis-
Hyperaesthesia in Sherrens triangle
Rovsing sign—pain elicited in the right lower quadrant with palpation pressure in the left lower quadrant
Psoas sign RLQ pain with extension of the right hip or with flexion of the right hip against resistance.
Baldwing test- Retrocecal appendicitis, pressure is applied in the right lower quadrant. lift the right leg with the knee straight. drop the leg.

Type of appendicitis-
The two types of appendicitis depending on the onset, which are:
Acute Appendicitis - It develops very fast within a few days to hours, and requires prompt medical treatment or surgery.
Chronic Appendicitis - rare condition.

Diagnosis-

Physical exam to assess your pain- apply gentle pressure on the painful area. When the pressure is suddenly released, appendicitis pain will often feel worse.
Blood test- high white blood cell (leucocyte) count.
Urine test- urinary tract infection or a kidney stone

Imaging tests-
Abdominal X-ray ( Plain or barium enema )
Abdominal ultrasound
CT scan
magnetic resonance imaging (MRI)

Treatment-
Conservative treatment-

A- Anti-anxiety (benzodiazepine , alprazolam , diazepam)
Anti-biotics( metronidazole , ciprofloxacin)
B- beta- adrenergic (atenolol , propranolol) for decrease BP
C- Carbonic anhydrase inhibitor (acetazolamide)
D- Diuretics (furosemide)
E- Anti-emetic (dexamethasone)

Surgical management-
Open appendectomy- mc-burneys incision
Laparoscopic appendectomy

Note-
Difficult cases- Retrograde appendicectomy can be done.
In presence of pus or burst appendix, peritoneal cavity is drained.
Appendicular tumour may be found.
If it is in the tip, appendicectomy is sufficient.
If it is in the base right hemicolectomy is done

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