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The presentation of acute appendicitis includes acute abdominal pain, nausea, vomiting, and fever. As the appendix becomes more swollen and inflamed, it begins to irritate the adjoining abdominal wall. This leads the pain to localize at the right lower quadrant. This classic migration of pain may not appear in children under three years.
MRI scan is less readily available than CT scan or ultrasound in hospitals to diagnose IAIs. However, it has been proposed to be used in those who are pregnant and have inconclusive findings on ultrasound. The sensitivity and specificity of MRI in diagnosing acute appendicitis are 94% and 96% respectively. [2]
Common causes of an acute abdomen include a gastrointestinal perforation, peptic ulcer disease, mesenteric ischemia, acute cholecystitis, appendicitis, diverticulitis, pancreatitis, and an abdominal hemorrhage. However, this is a non-exhaustative list and other less common causes may also lead to an acute abdomen. [2]
Acute appendicitis: Tillaux's triad: soft fluctuant swelling in umbilical region, swelling moves perpendicular to messentery, zone of resonance all around swelling: Mesenteric cyst: Rigler's triad: small bowel obstruction, a gallstone outside the gallbladder, and air in the bile ducts: Gallstone ileus: Wilkie's syndrome (SMA syndrome)
A new analysis found that outpatient management of appendicitis with antibiotics is safe for selected patients, which may allow people to avoid hospitalization
The work is named after Tinsley R. Harrison of Birmingham, Alabama, who served as editor-in-chief of the first five editions and established the format of the work: a strong basis of clinical medicine interwoven with an understanding of pathophysiology.
In the clinical context, it is performed when acute appendicitis is suspected. In this condition, the appendix becomes inflamed and enlarged. The appendix may come into physical contact with the obturator internus muscle, which will be stretched when this maneuver is performed on the right leg.
In some cases, the appendicitis resolves completely; more often, an inflammatory mass forms around the appendix. This is a relative contraindication to surgery. The appendix is also used for the construction of an efferent urinary conduit, in an operation known as the Mitrofanoff procedure , [ 26 ] in people with a neurogenic bladder .