Appendicitis
Intro
Appendicitis is one of the most common causes of acute abdominal pain. It is defined as inflammation of the vermiform appendix that occurs most commonly in adolescents and young adults. The inflammation may be cause by a virus, parasites, bacteria, trauma, or postoperative fecal stasis. It is a serious disease that usually requires surgery.
Signs and Symptoms
* indicates the most common signs and symptoms
Referral Pattern
Individuals will experience right lower quadrant or flank pain, periumbilical and/or epigastric pain. The onset of pain is usually gradual and poorly localized. The pain may be first vague, but intense enough to wake you up at night. Individuals may present with abdominal muscular rigidity which causes pain to come in waves, then becomes steady, and aggravates movements. This causes the individual to bend over and tense their abdominal muscles or lie down to draw the legs up to relieve the abdominal muscle tension.
Special tests
Appendicitis is one of the most common causes of acute abdominal pain. It is defined as inflammation of the vermiform appendix that occurs most commonly in adolescents and young adults. The inflammation may be cause by a virus, parasites, bacteria, trauma, or postoperative fecal stasis. It is a serious disease that usually requires surgery.
Signs and Symptoms
- Classic symptoms: pain preceding nausea and vomiting and low-grade fever in adults. Children tend to have higher fevers.
- Periumbilical and/or epigastric pain*
- Right lower quadrant or flank pain*
- Anorexia*
- Right thigh, groin, or testicular pain
- Abdominal muscular rigidity
- Dysuria (painful or difficult urination)
- Coated tongue and bad breath
* indicates the most common signs and symptoms
Referral Pattern
Individuals will experience right lower quadrant or flank pain, periumbilical and/or epigastric pain. The onset of pain is usually gradual and poorly localized. The pain may be first vague, but intense enough to wake you up at night. Individuals may present with abdominal muscular rigidity which causes pain to come in waves, then becomes steady, and aggravates movements. This causes the individual to bend over and tense their abdominal muscles or lie down to draw the legs up to relieve the abdominal muscle tension.
Special tests
- Hop Test
- Rebound tenderness or Blumberg's Sign
- McBurney's Point
- Rovsing's Sign
- Psoas Sign
- Obturator Sign
References:
Goodman, MBA, PT, C. C., & Snyder, MN, RN, OCN, T. E. (2007). Differential Diagnosis PHYSICAL THERAPISTS Screening for Referral (4thth ed.). St. Louis, MO: Saunders Elsevier
Pisarra, V. H. (2001, June). Recognizing the Various Presentations of Appendicitis. Dimension of Critical Care Nursing, 20(3), 24-27.
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