Acute

Appendicitis
Clinical Case
Student: Castillo, Alisbel
Introduction

Acute appendicitis is the acute inflammation of the appendix,

typically due to an obstruction of the appendiceal lumen. It is the
most common cause of acute abdomen requiring emergency
surgical intervention in both children and adults.
The exact cause of acute appendicitis is not always clear, but it
may be related to blockage of the appendix due to a buildup of
fecal matter, enlarged lymphoid tissue, or other causes.
 01
Brief Literature review
 Acute Appendicitis
Definition Etiology Clinical signs Clinical features.

•Acute inflammation of the •Lymphoid tissue •McBurney point •Migrating abdominal pain.
vermiform appendix. hyperplasia. tenderness •Nausea
•Appendiceal fecalith. •Anorexia
•Neoplasm. •Vomiting
•Parasitic infestation. •Low-grade fever
•Diarrhea
•Constipation

Diagnostics Treatment

•Acute appendicitis is •The treatment of choice is

usually a clinical diagnosis
supported by laboratory
findings.
• Confirmatory imaging is
recommended if the
diagnosis is uncertain.
appendectomy under
general anesthesia, after
administering prophylactic
antibiotics during
anesthetic induction and
hydroelectrolyte
replacement.
 Patient
30-year-old male patient comes to the
emergency department with severe abdominal
pain localized in the right lower quadrant. He
describes the pain as sharp and constant,
worsening over the past 24 hours.
 Chief Complaint
Abdominal Pain.

Present Ilness
The patient reports experiencing mild abdominal discomfort a day ago, which
progressively worsened overnight. He describes the pain as sharp and constant,
aggravated by movement and deep inspiration. He denies any diarrhea or changes
in bowel habits. He also reports nausea and a low-grade fever

Family History
Here is no family history of gastrointestinal disorders or surgical conditions.
 Physical Examination

Other
Vital Signs: General: Abdomen:
Systems:

Inspection reveals
Temperature:
The patient guarding and
100.4°F (38°C)
appears tenderness in the right No other
Blood Pressure:
uncomfortable lower quadrant. significant
120/80 mmHg
and is lying still Rebound tenderness is findings on
Heart Rate: 100
on the elicited. McBurney's examination.
bpm
examination point is tender on
Respiratory Rate:
table.- palpation. Bowel
18 bpm
sounds are diminished.
Diagnostic testing and results
 Differential diagnosis Definitive diagnosis

● Ectopic pregnancy
● Pseudoappendicitis
● Meckel diverticulum Acute appendicitis
● Diverticulitis (especially in elderly
patients)
● Psoas abscess (in patients with a
positive psoas sign)
● Inflammatory bowel diseas
 Therapeutic interventions

Appendectomy: surgical removal of the appendix, usually within 24

hours of the diagnosis.
 Follow-up and
outcomes
Postoperatively, the symptoms
resolve, and he is discharged
home on postoperative day 5.
A repeat laboratory evaluation
showed normalization of his white
blood cell count.
Physical examination revealed
well-healed surgical incisions
without signs of infection or wound
dehiscence.
Reflection on Case
Management:
The management of this case of acute
appendicitis involved a multidisciplinary
approach aimed at achieving timely diagnosis,
effective treatment, and optimal patient
outcomes.
One key aspect of case management was the
prompt recognition the symptoms and their
correlation with acute appendicitis.
 Conclusions

This case highlights the importance of a systematic approach to the diagnosis

and management of acute appendicitis. Early recognition of symptoms,
thorough clinical evaluation, and prompt surgical intervention are essential in
preventing complications and optimizing patient outcomes.
 References
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Pathophysiology, Diagnosis, Management. Elsevier Saunders; 2016
3.Martin RF. Acute appendicitis in adults: Clinical manifestations and differential diagnosis.
In: Post TW, ed. UpToDate .Waltham,
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manifestations-and-differential-diagnosis#H5346248.Last updated February 4, 2016. Accessed
December 11, 2016.
4.Appendiceal Cancer and Tumors. https://rarediseases.org/rare-diseases/appendiceal-cancer-
tumors/. Updated: December 31, 2017. Accessed: June 4, 2019.
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THANKS.