PPT on Appendicitis by Mr. ASHOK BISHNOI
Post on 07-May-2015
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Appendicitis
Mr. ASHOK BISHNOILecturer JINR
Anatomy &physiology of appendix:-
The appendix is a slender, worm-shaped pouch, averaging 5-10cm in length, that protrudes from the top of the colon in the lower right abdomen.
Blood & nerve supply:- Blood supply by -Appendix artery from
ileocolic artery.
Blood return by -Appendix vein -portalal vein
Nerve supply by -Sympathetic nerve.
Definition:-
“It is inflammation of the vermiform appendix”
Incidence:-
Occurs mainly in 10 to 30 year of age.
Etiology:-
Obstruction (accumulated feces in lumen)
TumorForeign bodiesKing-King of appendix (Twisting)Swelling of the bowel wall
Types of appendicitis:-Four type:1.Acute simple appendicitis
2.Acute purulent appendicitis
3.Perforation and gangrenous
4.Appendiceal abscess
1.Acute simple appendicitis-
2.Acute purulent appendicitis-
3.Perforation and gangrenous-
Gangrenous
Perforation
4.Appendiceal abscess-
Pathophysiology:-
Due to etiological factor
Inflammatory process
Increase intra-luminal pressure
Severe pain
Clinical manifestation:-Subjective sign & symptoms- Epigastric pain spread to right lower
quadrant. Malaise Anorexia Vomiting Moderate leukocytosis ( leukocyte in blood)
Rebound tenderness Constipation Diarrhea
Objective sign & symptoms- Pain at McBurney’s point.(between umbilical &
iliac crest)
Rovsing’s sign: (pain in the right lower quadrant upon palpation of the left lower quadrant)
Obturator sign: (pain on internal and external rotation of the hip)
Psoas sign : (pain on active elevation of the legs)
Tachycardia Tachypnoea Low grad fever
Diagnostic evaluation:-
History Physical examination WBC count Urinalysis Abdominal x-ray CT Scan USGpregnancy test (women only)
Management:- Medical management- Bed rest NPO I/V fluid Antibiotic eg. Ampicillin, Sulbactam, Gentamycin
Antipyretic Antiemetic Analgesic
Surgical management-
Appendectomy
New method-
laparoscopy appendectomy
Incision-
McBurney’s
incision
transvers skin incision
Operation- Process: Appendix is divided between
clamps and ligated
a
b c
Complication:- Abdomen abscess
Perforation
Peritonitis
Infection
Nursing management:-
Pre-operative-Pain R/t inflamed appendix.Fluid volume deficit R/T vomiting.
Post-operative-Risk for infection R/T Perforation.Altered nutrition less then body requirement
R/t less intake of food.
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