M/2 Position

of Appendix
Retrolecal
V

Pelvic
v
-

I
Post-Ileal (least)
Appendicular Astery
blanch
is
of
Lower Division of
IhoColic
Astery
M/c cause
of
Luminal Obstruction

of Appendix
Fecolith
MANTRELS/Modified
Alvorado
Score?
 =M ->
nigration of pain to Rt. lower
quad.
I

A -
> Anorexia
b
Vomiting
=

~N -> Nausea/
I

2 =
↑->
Tenderness in Rt. Lower
quadrant.
b R-rebound
~
pain
- a -> temp.
alevated
↳

2
- L-> Leukocytosis
~S-shiftof
wic to left.
I
-

10
-
 Acc. to modified
Avocado score

score of Appendicitis
-

unlikely
- -
 <5
·

<5- unlikely
5)6 -

possible
78- likely

9/10-Highlylikely
eusing Sign
Pain Rt.
in Ihac
fossa when

is
Lt. Iliac
fossa pressed.

of
Cdltshifting
bowel gaseusion)
 ·DasSign
I
flexion
Hyperextension
of Rt.
nip against
Resistance
-
↓
results in

?
Pain in it. Iiac fossa
3 DID
of Appendicitis
Childrens
Infants ↑
in
·

Yessima inf
Diverticulum
Meckel's
·

· Intussusception
 IOC -

Appendicitis

-> Adult =

-> Children=
Adult:CECT

Children USG
=
open
Appendicectomy
incision
Muscle cutting
 Mason Incision
Rutherford
open
Appendicectomy
Muscle
o 0

Inceston
0 splitting
Grid IronIncision
which incision is used

Appendicectomy
for Elective
Lanz/Skin Crean/Bikini Incision
How locate
to
appendix
is
after pesitoneum
open?
Base
of Appendixis
out of
always
/x of 3 taenia Coli
In
Appendicectomy
A
0

I Appendixis
&
not

inflammed
↓
What to do?
I
-
 last2
search feetof
item fos
D

neckels Diverticulum
inflammed
In
Appendicectomy
A
is
if base
gangrenous
acent recal
along wall. ady
=
1st Hemicolectomy
M/c complication
following Appendicectomy
Wound
Infection/
surgical
site
Infection
mic lite of ↑

perforation
-

Appendicular
Tip of Appendix
 lamp
Appendicular
managed by
is
 -

Oschner Sheese
--
Regime
Ro disease
freedom from
=

R =-
disease

Re
=

-
disease
So:
microscopic freedom
R= microscopic dis

die
R2 Gross
=