Appendicitis

 APPENDIX – a small finger like appendages about 10cm
long that is attached to the cecum just below the ileocecal

valve.
 APPENDICITIS – is the inflammation of the vermiform
appendix caused by an obstruction of the intestinal lumen
from infection, stricture, fecal mass, foreign body, or tumor.
 ROVSING’S SIGN – an indication of acute appendicitis in
which pressure on the left lower quadrantof the abdomen
causes pain in the right lower quadrant.
 LAPAROSCOPY – technique to examine the abdominal
cavity with a laparoscope through one or more small
incision in the abdominal wall, usually at the umbilicus.
 PERITONITIS –inflammation of the peritoneum.
 ABSCESS- collection of pus.
 Tenderness elicited by palpating the right lower
quadrant over the Mc Burney’s point
 Indicator of localized peritoneal inflammation in acute
appendicitis.
 Eliciting the Mc Burney’s sign
 Place patient to supine position, knees slightly flexed
and abd. Muscle relaxed.
 Palpate deeply and slowly in the RLQ over the Mc
Burney’s point (Located about 2”(5cm) from the right
anterior superior spine of the ileum, on the line
between the spine and the umbilicus. Point of pain and
tenderness, a positive Mc Burney’s sign, indicates
appendicitis.
 The appendix is a blind-ending tube that comes off
of the first part of the colon, the cecum. In fact, the
appendix resembles a worm arising from the
colon, hence its full name vermiform appendix
which in Latin means worm.The appendix has no
known function. It is believed that it may have a
role in the immune system.
 The main thrust of events leading to the
development of acute appendicitis lies in the
appendix developing a compromised blood
supply due to obstruction of its lumen and
becoming very vulnerable to invasion by
bacteria found in the gut normally.
 Obstruction of the appendix lumen by faecolith,

enlarged lymph node, worms, tumour, or indeed
foreign objects, brings about a raised intra-
luminal pressure, which causes the wall of the
appendix to become distended.
 Normal mucus secretions continue within
the lumen of the appendix, thus causing
further build up of intra-luminal pressures.
This in turn leads to the occlusion of the
lymphatic channels, then the venous return,
and finally the arterial supply becomes
undermined.
 Reduced blood supply to the wall of the

appendix means that the appendix gets little
or no nutrition and oxygen. It also means a
little or no supply of white blood cells and
other natural fighters of infection found in
the blood being made available to the
appendix.
 The wall of the appendix will thus start
to break up and rot. Normal bacteria
found in the gut gets all the inducement
needed to multiply and attack the
decaying appendix within 36 hours from
the point of luminal obstruction,
worsening the process of appendicitis.
 This leads to necrosis and perforation of
the appendix. Pus formation occurs when
nearby white blood cells are recruited to
fight the bacterial invasion.
 A combination of dead white blood cells,
bacteria, and dead tissue makes up pus.
 The content of the appendix (faecolith,
pus and mucus secretions) are then
released into the general abdominal
cavity, bringing causing peritonitis.
 So, in acute appendicitis, bacterial
colonisation follows only when the
process have commenced.
 These events occur so rapidly, that the
complete pathophysiology of
appendicitis takes about one to three
days. This is why delay can be deadly
 Periumbilical pain progresses to right
lower quadrant pain and is usually
accompanied by a low grade fever and
nausea.
 Loss of appetite
 Rebound tenderness
 Rovsing’s sign
 Positive Mc Burney’s sign
 Constipation
 COMPLETE BLOOD COUNT - it
demonstrate an elevated WBC count
with an elevation of the neutrophils.
 Abdominal x-ray films
 Ultrasound
 CT scan
 Perforation
 Abscess
 Peritonitis
 Immediate surgery
 Administration of IV fluids and

antibiotic - To correct or prevent
fluid and electrolyte imbalance,
dehydration and sepsis until surgery
is performed.
 Relieving Pain
 Preventing Fluid Volume Deficit
 Reducing Anxiety
 Eliminating Infection
 Maintaining Skin Integrity
 Attaining Optimal Nutrition
 Definition
 Appendectomy is the surgical
removal of the appendix. The
appendix is a worm-shaped
hollow pouch attached to the
cecum, the beginning of the
large intestine.
 Laparotomy
 Laparoscopy
 Basic Set
Basic Sharps, AP, OS, Babcock,

Silk
 All diagnostic tests and procedures are
explained to promote cooperation and
relaxation.
 The patient is prepared for the type of
surgical procedures as well as the post
operative care.
 Measures to prevent postoperative
complication are taught, including
coughing,turning, and deep breathing
using splint at the incision site.
 I.V fluids or total parenteral nutrition before
surgery maybe ordered to improved fluid
and electrolyte balance and nutritional
status.
 Intake and output is monitored
 Preoperative laboratory are obtained.
 Bowel cleansing will be initiated 1 to 2 days
before surgery for better visualization.
 Antibiotics are ordered to decrease the
bacterial growth in the colon.
 Patient may not have anything by mouth
after midnight the night before surgery.
 Medication may be withheld, if ordered.
Thiswill keep the GI tract clear.
 Position the patienton the OR table
 Skin preparation
 Induction of anesthesia
 Procedures done aseptically
 Closing of the incision
 Dressing of the site
 Monitor vital signs for sign of infection
and shock such as fever, hypotension and
tachycardia.
 Monitor I and O for sign of imbalance,
dehydration, and shock.
 Assess abdomen for increased pain,
distention, rigidity, and rebound
tenderness because these may indicate
postoperative complications.
 Evaluate dressing and incision.
 Evaluate the passing of flatus or feces
 Monitor for nausea and vomiting.
 Laboratory values are monitored and patient
is evaluated for sign and symptoms of
electrolyte imbalances.
 Wound drains, I.V, and all other catheter
are monitored and evaluated for signs of
infections.
 Turning , coughing, deep breathing, and
incentive spirometry are performed every 2
hours.
 Diet is advanced as ordered.
 Administration of medications as ordered
 Instruct patient to avoid heavy lifting for
4 to 6 weeks after surgery.
 Instruct patient to report symptoms of
anorexia, nausea, vomiting, fever,
abdominalpain, incisional redness and
drainage postoperatively.

Appendicitis

Uploaded by

Copyright:

Available Formats

Appendicitis

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Appendicitis

Uploaded by

Copyright:

Available Formats

 APPENDIX – a small finger like appendages about 10cm

long that is attached to the cecum just below the ileocecal

 Obstruction of the appendix lumen by faecolith,

 Reduced blood supply to the wall of the

 Administration of IV fluids and

Basic Sharps, AP, OS, Babcock,

You might also like