Appendicitis history and symptoms: Difference between revisions

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==Overview==
==Overview==
Common symptoms of appendicitis include right lower quadrant [[Abdominal Pain|pain]] in iliac fossa, [[vomiting]], [[fever]].


==Common Symptoms==
==History==
Symptoms of acute appendicitis can be classified into two types: typical and atypical (Hobler, K., 1998).
Obtaining the history is an important aspect in diagnosing appendicitis. It provides insight into causes, precipitating factors, and associated conditions. Complete history will help determine the correct therapy and helps in determining the prognosis. Asking specific questions about symptoms and health history will help rule out other conditions. The onset, location, severity of pain and knowing when other symptoms appeared relative to the pain is helpful. Questions about other medical conditions, previous illnesses and surgeries, and use of medications, alcohol, or illegal drugs are also included.
===Typical Symptoms===
Typical symptoms may include:
* [[Pain]] starting centrally (periumbilical) before localizing to the [[right iliac fossa]] (the lower right side of the abdomen)
** This is due to the poor localizing (spatial) property of visceral nerves from the mid-gut, followed by the involvement of somatic nerves (parietal [[peritoneum]]) as the [[inflammation]] progresses.
* Loss of appetite
* Fever may occur
* Nausea may occur
* Vomiting may occur


With the typical presentation of appendicitis the diagnosis of the disease is easier to make, surgery occurs earlier and findings are often less severe (Hobler, K., 1998).
==Symptoms==
Symptoms of acute appendicitis can be classified into two types, typical and atypical. With typical symptoms, diagnosis is easier to make and surgery occurs earlier. Findings are also less severe.<ref name="pmid29044790">{{cite journal |vauthors=Stringer MD |title=Acute appendicitis |journal=J Paediatr Child Health |volume=53 |issue=11 |pages=1071–1076 |year=2017 |pmid=29044790 |doi=10.1111/jpc.13737 |url=}}</ref><ref name="pmid29241958">{{cite journal |vauthors=Cameron DB, Williams R, Geng Y, Gosain A, Arnold MA, Guner YS, Blakely ML, Downard CD, Goldin AB, Grabowski J, Lal DR, Dasgupta R, Baird R, Gates RL, Shelton J, Jancelewicz T, Rangel SJ, Austin MT |title=Time to appendectomy for acute appendicitis: A systematic review |journal=J. Pediatr. Surg. |volume= |issue= |pages= |year=2017 |pmid=29241958 |doi=10.1016/j.jpedsurg.2017.11.042 |url=}}</ref>


==Less Common Symptoms==
Typical symptoms include:
Appendicitis presenting with atypical symptoms is more difficult to diagnose than normal.  [[CT]] scans and [[ultrasound]] tests are more useful in diagnosing the disease when these atypical symptoms present. Surgical findings are more apt to be severe in cases presenting with these symptoms ([[suppuration]], [[abscess]], [[perforation]], etc. (Hobler,K., 1998).
*Pain starting centrally ([periumibilical]) before localizing to the [[right iliac fossa]], which the lower side of the right [[abdomen]].
===Atypical Symptoms===
**This is usually due to poor localizing properties of the [[visceral nerves]] and involvement of somatic nerves as [[inflammation]] progresses.
Atypical symptoms may include:
*Loss of appetite
* Pain beginning and staying in the [[right iliac fossa]]
*[[Fever]]
* [[Diarrhea]]
*[[Nausea]] or [[vomiting]] may occur
* A more prolonged, smoldering course.
 
* Increased frequency of [[urination]]
Atypical symptoms include:
** This occurs when the inflamed appendix lies in contact with the bladder.
*Constant pain in the right iliac fossa
* With a post-ileal [[appendix]], marked [[retching]] may occur
*Prolonged [[diarrhea]]
*There is a possibility of [[micturition]] if an inflamed appendix lies in contact with the [[bladder]].  
*[[Tenesmus]] (the feeling that a bowel movement will relieve discomfort) can be experienced.
 
==References==
{{Reflist|2}}
{{WH}}
{{WS}}
 
[[Category:Emergency medicine]]
[[Category:Surgery]]
[[Category:Gastroenterology]]

Latest revision as of 20:27, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Farwa Haideri [2]

Overview

Common symptoms of appendicitis include right lower quadrant pain in iliac fossa, vomiting, fever.

History

Obtaining the history is an important aspect in diagnosing appendicitis. It provides insight into causes, precipitating factors, and associated conditions. Complete history will help determine the correct therapy and helps in determining the prognosis. Asking specific questions about symptoms and health history will help rule out other conditions. The onset, location, severity of pain and knowing when other symptoms appeared relative to the pain is helpful. Questions about other medical conditions, previous illnesses and surgeries, and use of medications, alcohol, or illegal drugs are also included.

Symptoms

Symptoms of acute appendicitis can be classified into two types, typical and atypical. With typical symptoms, diagnosis is easier to make and surgery occurs earlier. Findings are also less severe.[1][2]

Typical symptoms include:

Atypical symptoms include:

  • Constant pain in the right iliac fossa
  • Prolonged diarrhea
  • There is a possibility of micturition if an inflamed appendix lies in contact with the bladder.
  • Tenesmus (the feeling that a bowel movement will relieve discomfort) can be experienced.

References

  1. Stringer MD (2017). "Acute appendicitis". J Paediatr Child Health. 53 (11): 1071–1076. doi:10.1111/jpc.13737. PMID 29044790.
  2. Cameron DB, Williams R, Geng Y, Gosain A, Arnold MA, Guner YS, Blakely ML, Downard CD, Goldin AB, Grabowski J, Lal DR, Dasgupta R, Baird R, Gates RL, Shelton J, Jancelewicz T, Rangel SJ, Austin MT (2017). "Time to appendectomy for acute appendicitis: A systematic review". J. Pediatr. Surg. doi:10.1016/j.jpedsurg.2017.11.042. PMID 29241958.

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