Appendicitis history and symptoms: Difference between revisions

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==Overview==
==Overview==
Patients with appendicitis commonly present with pain near the navel that eventually localizes to the [[right iliac fossa]], [[loss of appetite]], [[fever]], [[nausea]], and [[vomiting]].
Common symptoms of appendicitis include right lower quadrant [[Abdominal Pain|pain]] in iliac fossa, [[vomiting]], [[fever]].
==Common Symptoms==
Symptoms of acute appendicitis can be classified into two types: typical and atypical (Hobler, K., 1998).
===Typical Symptoms===
Typical symptoms may include:
* Abdominal [[Pain]] which:
** Starts centrally ( in the periumbilical region) 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.
** Occurs suddenly, often causing a person to wake up at night
** Occurs before other symptoms
** Begins near the belly button and then moves lower and to the right
** Is new and unlike any pain felt before
** Gets worse in a matter of hours
** Gets worse when moving around, taking deep breaths, [[coughing]], or [[sneezing]]
* 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).
==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.


==Less Common Symptoms==
==Symptoms==
Appendicitis presenting with atypical symptoms is more difficult to diagnose than with typical symptoms. [[CT]] scans and [[ultrasound]] is more useful in the diagnosis of the disease when these atypical symptoms present. Surgical findings ([[suppuration]], [[abscess]], [[perforation]], etc.) are more apt to be severe in cases presenting with these symptoms (Hobler,K., 1998).
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>
===Atypical Symptoms===
 
Atypical symptoms may include:
Typical symptoms include:
* Pain beginning and staying in the [[right iliac fossa]]
*Pain starting centrally ([periumibilical]) before localizing to the [[right iliac fossa]], which the lower side of the right [[abdomen]].
* [[Diarrhea]]
**This is usually due to poor localizing properties of the [[visceral nerves]] and involvement of somatic nerves as [[inflammation]] progresses.
* A more prolonged, smoldering course.
*Loss of appetite
* Increased frequency of [[urination]]
*[[Fever]]
** This occurs when the inflamed [[appendix]] lies in contact with the [[bladder]].
*[[Nausea]] or [[vomiting]] may occur
* With a post-ileal [[appendix]], marked [[retching]] may occur
 
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==
==References==
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{{Reflist|2}}
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[[Category:Primary care]]
 
[[Category:emergency medicine]]
[[Category:Emergency medicine]]
[[Category:Inflammations]]
[[Category:Surgery]]
[[Category:Medical emergencies]]
[[Category:General surgery]]
[[Category:Gastroenterology]]
[[Category:Gastroenterology]]
[[Category:Disease]]
[[Category:Needs content]]

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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