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  • Appendicitis: Morning Report

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    Raja Della Marta
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    A 10-year-old female presented to the hospital with severe pain in the lower right abdomen that began one day prior. Her symptoms included sharp intermittent pain that migrated to the right lower quadrant, fever, nausea and vomiting. Her physical exam revealed tenderness and positive test signs for appendicitis. Her lab work showed leukocytosis. With a high Alvarado score of 10, the working diagnosis was acute appendicitis, which was then treated surgically with an appendicectomy.

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    ApenDiciTis

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    A 10-year-old female presented to the hospital with severe pain in the lower right abdomen that began one day prior. Her symptoms included sharp intermittent pain that migrated to the right lower quadrant, fever, nausea and vomiting. Her physical exam revealed tenderness and positive test signs for appendicitis. Her lab work showed leukocytosis. With a high Alvarado score of 10, the working diagnosis was acute appendicitis, which was then treated surgically with an appendicectomy.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
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    11 views16 pages

    Appendicitis: Morning Report

    Uploaded by

    Raja Della Marta
    A 10-year-old female presented to the hospital with severe pain in the lower right abdomen that began one day prior. Her symptoms included sharp intermittent pain that migrated to the right lower quadrant, fever, nausea and vomiting. Her physical exam revealed tenderness and positive test signs for appendicitis. Her lab work showed leukocytosis. With a high Alvarado score of 10, the working diagnosis was acute appendicitis, which was then treated surgically with an appendicectomy.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 16

    Morning report

    Appendicitis
    22 July 2011

    Agrita, Putri Ingen, Winda

    Chief Complaint :
    ID: Patient A, female, 10 years old,
    chief complain : severe pain at right
    lower abdomen
    since one
    day before addmision to the hospital

    History :
    Since 1 day before admitting to hospital

    the patient complained abdominal pain


    which started at the upper central
    abdomen.
    The
    pain described as sharp and
    intermittant pain. No relation to eating
    habit. No history of trauma, Nausea and
    vomitting (+) containing food eaten (not
    projectile)
    Fever (+) no sweating, no shivvering.
    Occurred a few hours after pain.
    No complain of mixturation and defecation.

    A few hours later, pain migrated to

    right lower quadrant


    Pain is sharp and continuously

    Past illness history:


    No history of abdominal trauma
    No history of the same illness before

    HABITUATION HISTORY
    Rarely eating fruits and vegetables
    Rarely drinking sufficient water

    Physical Exam
    Generalized condition : looks mild illness
    Conciousness
    : composmentis
    Vital sign
    :
    BP : 100/70mmHg
    RR : 23 x/minutes
    P : 104x/minutes
    T : 38,1 C

    Physical Exam
    Head and Neck : normal
    Lungs
    : clear to auscultation bilaterally,
    Heart
    : Regular rate and rhythm, no

    murmur,
    Abdomen
    : Localized status
    Extremity
    : Warm, well-perfused
    Limph node
    : no enlargement on
    palpation

    Localized state
    Abdomen
    I : symetrical, Distended (-), scar (-)
    no skin Redness,
    A: Bowel sounds (+)normal
    Pl : tenderness (+),
    Pr: Tympani

    Sepecific exam
    Abdomen
    o Rovsing sign (+),
    o Blumberg sign (+)
    o Psoas sign (+),
    o Obturator sign (-),

    Alvarado score
    Symptoms
    Anorexia : 1
    nausea/ vomiting: 1
    Sign
    Migration to the right iliac fossa : 1
    Tenderness in the right iliac fossa :2
    Rebound pain : 1
    Elevated temperature : 1
    Laboratory findings
    Leukocytosis:2
    Shift of leukocytes to the left : 1
    TOTAL : 10
    Apendicitis highly likely

    Working Diagnosis
    Acute Appendicitis

    Further examination
    Routine blood Examination
    USG Abdomen

    Laboratory Findings
    Hb
    : 12,4 gr%
    White blood cel
    : 21.200/ mm3
    Platelet
    : 319.000 / mm3

    Management
    Operative
    appendictomy

    Thank you

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