Post on 11-Apr-2017
Presented by-Neha Maurya
1. The Appendix is… 2. McBurney’s Point
Caecum
Here!
Causes•An obstruction:Food waste or a hard piece of stool (fecal stone) can block the opening of the cavity
•An infection:Appendicitis may also follow an infection, such as a gastrointestinal viral infection, or it may result from other types of inflammation.•Traumatic injury to the abdomen
PATHOPHYSIOLOGY
Appendix become obstructed
Increase intra-luminal pressure
Decrease venous drainage, thrombosis, Edema& bacterial invasion
Appendix become hyperemic, warm& covered with exudates
Perforation& gangrene of appendix
Obstruction
Distention
Distention causing ischemia
muc
us
Peritoneal inflammation
Gangrene
SIGNS/SYMPTOMS
• The main symptoms is pain in abdomen(Rovsing’s & Psoas sign)
• Swelling• Loss of appetite• N/V• Constipation or diarrhoea• Low fever• Inability to pass gas
Diagnostic evaluation • Medical history and physical examination
• Laboratory tests-WBC (10,000-18,000 mm3 )& neutrophils elevated-C-reactive protein elevated-urine analysis -electrolytes
• Imaging tests-Ultrasound of the lower abdomen-Abdominal computed tomography (CT scans)
COMPLICATION • Peritonitis
• Abscess
• Sepsis
• Perforation
MANAGEMENTMEDICAL TREATMENT:
1. Supportive and symptomatic managementAntibiotics/fluids etc.
SURGICAL TREATMENT:
2. Treatment of underlying cause is-
Appendectomy(laparoscopic& open)
Laparoscopic surgery(“key hole surgery”)
Open surgery
Nursing ManagementPre – Operative
NPO status upon admissionAdminister IV fluids as prescribedSemi-Fowler’s position to contain abdominal drainage in the
lower abdomenAvoid laxatives/enemas or application of heat that could cause
perforation
Post – OperativeAdminister opioid analgesia (morphine sulfate)Administer IV antibiotics as orderedFor peritonitis, monitor NG tube drainageFor perforation or abscess, monitor surgical drains.
TSM
U. S
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N1
Thank U 4 your attention. Questions?