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

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Thank U 4 your attention. Questions?