Appendicitis physical examination: Difference between revisions

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VisualWikitext

Latest revision as of 20:27, 29 July 2020

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

Overview

Patients with acute appendicitis usually appear in pain and distress. Physical examination of patients with appendicitis is usually remarkable for fever and mild tachycardia. Even minimal pressure on the abdomen can elicit a marked pain to patient.

Physical Examination

Vitals

Skin

Abdomen

The abdominal wall is very sensitive to mild palpation.
Rebound tenderness
Abdominal guarding
Rovsing's sign
Psoas sign
Obturator sign^[2]
A digital rectal examination elicits tenderness in the rectovesical pouch in special cases of appendicitis.

References

↑ Hardin, M. Acute Appendicitis: Review and Update. Am Fam Physician".1999, Nov 1;60(7):2027-2034
↑ Stockman III, James A. (2012), Year Book of Pediatrics 2012 (2012 ed.), Maryland Heights, MO: Mosby

Template:WH Template:WS

[1] Hardin, M. Acute Appendicitis: Review and Update. Am Fam Physician".1999, Nov 1;60(7):2027-2034

[2] Stockman III, James A. (2012), Year Book of Pediatrics 2012 (2012 ed.), Maryland Heights, MO: Mosby

[1]

[2]

@@ Line 1: / Line 1: @@
+__NOTOC__
 {{Appendicitis}}
-{{CMG}}
+{{CMG}} {{AE}} {{FH}}
 ==Overview==
-Physical examination will mostly be focused on abdominal findings. The patient may be ill appearing, in pain, with a fever and mild tachycardia. Even minimal pressure on the abdomen may elicit a marked response from the patient due to pain.
+Patients with acute appendicitis usually appear in pain and distress. Physical examination of patients with appendicitis is usually remarkable for fever and mild [[tachycardia]]. Even minimal pressure on the [[abdomen]] can elicit a marked pain to patient.
-==Appearance of the Patient==
+==Physical Examination==
-Patient is usually ill appearing, may be of any age but more likely to be a child. They may be doubled over in pain, appearing distressed.
+===Vitals===
+*[[Fever]]
+*[[Tachycardia]]
+*[[Hypotension]]
+*[[Tachypnea]]<ref>Hardin, M. Acute Appendicitis: Review and Update. ''Am Fam Physician".1999, Nov 1;60(7):2027-2034''</ref>
-==Vitals==
+===Skin===
-===Temperature===
+*[[Diaphoresis]]
-*A [[fever]] is often present
+*[[Pallor]]
-===Pulse===
+===Abdomen===
-====Rate====
+* The abdominal wall is very sensitive to mild palpation.
-*[[Tachycardia]] may be present
-====Rhythm====
-*The pulse is regular
-====Symmetry====
-*The pulses may be asymmetric
-===Blood Pressure===
-*[[Hypotension]] may be present
-===Respiratory Rate===
-*[[Tachypnea]] may be present, or breathing patterns may be altered by patient to compensate for abdominal pain
-==Skin==
-* [[Diaphoresis]] may be present
-* [[Pallor]] may be present
-==Abdomen==
-* Abdominal wall very sensitive to mild palpation.
 * [[Rebound tenderness]]
 * [[Abdominal guarding]]
 * [[Rovsing's sign]]
-** Deep palpation of the [[left iliac fossa]] may cause pain in the [[right iliac fossa]]
 * [[Psoas sign]]
-** Occasionally, an inflamed appendix lies on the [[psoas]] muscle and the patient will lie with the right hip flexed for pain relief.
+*[[Obturator sign]]<ref>{{Citation
-* [[Obturator sign]]
+| last1  = Stockman III
-** If an inflamed [[appendix]] is in contact with the [[obturator internus]], spasm of the muscle can be demonstrated by flexing and internally rotating the hip.
+| first1 = James A.
-** This maneuver will cause pain in the [[hypogastrium]]
+| lastauthoramp = yes
+| title     = Year Book of Pediatrics 2012
+| publisher = Mosby
+| place     = Maryland Heights, MO
+| edition = 2012
+| year    = 2012
+}}</ref>
+* A digital rectal examination elicits tenderness in the [[rectovesical pouch]] in special cases of appendicitis.
+==References==
+{{Reflist|2}}
+{{WH}}
+{{WS}}
-==Other==
+[[Category:Emergency medicine]]
-* A digital rectal examination elicits tenderness in the [[rectovesical pouch]] in special cases of appendicitis
+[[Category:Surgery]]
-** In case of a retrocaecal appendix even deep pressure in the right lower quadrant may fail to elicit tenderness
+[[Category:Gastroenterology]]
-** If the appendix lies entirely within the pelvis, there is usually complete absence of the abdominal rigidity