R / Female / 19 yoMay, 27th 2015

Chief Complaint: Pain on the Right Lower Abdominal

It has been suffered since 4 days before come to Pirngadi Hospital. initially, The patient come to clinic and consume antibiotics . Pain is felt to be intermittent. History of fever (+), nausea (+), vomiting (+). Flatus (+) Urination (+) Normal.

Previous Disease: UnknownPrevious Medication: Unknown

PRESENT STATE

Awarness: AlertBlood Pressure: 110/70 mmHgHeart Rate: 98 x/min Respiratory rate: 28 x/minTemperature: 38.2 C

PHYSICAL EXAMINATIONHead : Eye : Conjungtiva anemic (-/-), sklera icteric (-/-)Ear / Nose / Mouth: in normal limitNeck : in normal limitThorax :Inspection : symetricPalpation: Fremitus tactile right = leftPercussion: sonorAuscultation: vesicular

Localized state AbdominalInspection: Symmetric, distention (-)Palpation: soepel, pain o/t (R) iliaca region (+)Percussion: Tympani Auscultation: Peristaltic (+) N

Digital Rectal Examination :perineum was normal, anal sphincter tone was tight, smooth mucosal, rectal ampule feses (+), pain encountered in 10 hoursgloves : faeces/blood/mucus : +/-/-

Superior/Inferior Extremity : Normal

Laboratory

Hb/Ht/Leu/Tro = 10,00/31,90/12.100/311.000Kgd ad random = 114 mg/dlUreum /creatinin = 12,83/0,67NA/K/CL = 146/3.50/116

Thorax X-Ray

Diagnose :Appendicitis Acute

TreatmentIn Emergency RoomFasting IVFD RL 20 drops/minInj. antibiotic ChateterPatient was prepared for "Appendictomy"

Clinical Photo

Durante Operation

The end,.Thank you