Appendicular abscess physical examination: Difference between revisions

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{{Appendicular abscess}}
{{Appendicular abscess}}
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==Overview==
==Overview==
Physical examinations mostly focus on [[abdominal]] findings. The patient may appear [[toxic]] with diffuse [[abdominal pain]] and high grade fever and [[tachycardia]]. Even minimal pressure on the [[abdomen]] can elicit a marked response from the patient due to pain.


==Physical examination==
==Physical examination==
===Vitals===
===Vitals===
*[[Fever]]
*[[High fever|High grade fever]]
*[[Tachycardia]]
*[[Tachycardia]]
*[[Hypotension]]
*[[Hypotension]](If its associated with rupture)
*[[Tachypnea]] <ref>Hardin, M. Acute Appendicitis: Review and Update. ''Am Fam Physician".1999, Nov 1;60(7):2027-2034</ref>  
*[[Tachypnea]] <ref>Hardin, M. Acute Appendicitis: Review and Update. ''Am Fam Physician".1999, Nov 1;60(7):2027-2034</ref>


===Skin===
===Skin===
*[[Diaphoresis]]  
*[[Diaphoresis]]  
*[[Pallor]]  
*[[Pallor]]  
*Cold extremities
*[[Cold extremities]]
 
===Neck===
*No masses
 
===Cardiovascular system===
*Regular rate and rhythm
*[[Heart sounds|Normal S1, S2]]
*No [[murmurs]], rubs, or [[Gallops and Extra Heart Sounds|gallops]]
 
===Lungs===
Bilateral normal [[vesicular]] [[breath]] sounds.


===Abdomen===
===Abdomen===
* The abdominal wall is very sensitive to mild palpation.
* The [[abdominal wall]] is very sensitive to mild palpation.
* [[Rebound tenderness]]
*Characteristic signs of [[appendicitis]] may not be present in [[abscess]].  
* [[Abdominal guarding]]
* [[Rebound tenderness]] and [[abdominal guarding]] can or cannot be elicited.
* [[Rovsing's sign]] Deep palpation of the [[left iliac fossa]] may cause pain in the [[right iliac fossa]].
* [[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.
* [[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]] 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.This maneuver will cause pain in the [[hypogastrium]].<ref>{{Citation
*[[Obturator sign]] 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]].This maneuver will cause pain in the [[hypogastrium]].<ref>{{Citation
| last1  = Stockman III
| last1  = Stockman III
| first1 = James A.  
| first1 = James A.  
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| year    = 2012
| year    = 2012
}}</ref>
}}</ref>
* A digital rectal examination elicits tenderness in the [[rectovesical pouch]] in special cases of appendicitis.<ref name="wiki1"> Appendicitis. Wikipedia (2016). https://en.wikipedia.org/wiki/Appendicitis Accessed on March 14th, 2016</ref>In case of a retrocaecal appendix even deep pressure in the right lower quadrant may fail to elicit tenderness. If the appendix lies entirely within the pelvis, there is usually complete absence of abdominal rigidity.
* A digital rectal examination elicits tenderness in the [[rectovesical pouch]] in special cases of appendicitis. In case of a retrocaecal appendix even deep pressure in the right lower quadrant may fail to elicit tenderness. If the appendix lies entirely within the pelvis, there is usually complete absence of abdominal rigidity.<ref name="wiki1"> Appendicitis. Wikipedia (2016). https://en.wikipedia.org/wiki/Appendicitis Accessed on March 14th, 2016</ref>
 
===Neurological===
Alert, oriented X 3


==References==
==References==
{{reflist|2}}
{{reflist|2}}
[[Category:Disease]]
[[Category:Up-To-Date]]
[[Category:Gastroenterology]]
[[Category:Surgery]]
[[Category:Emergency medicine]]
[[Category:Infectious disease]]

Latest revision as of 20:28, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

Overview

Physical examinations mostly focus on abdominal findings. The patient may appear toxic with diffuse abdominal pain and high grade fever and tachycardia. Even minimal pressure on the abdomen can elicit a marked response from the patient due to pain.

Physical examination

Vitals

Skin

Neck

  • No masses

Cardiovascular system

Lungs

Bilateral normal vesicular breath sounds.

Abdomen

Neurological

Alert, oriented X 3

References

  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
  3. Appendicitis. Wikipedia (2016). https://en.wikipedia.org/wiki/Appendicitis Accessed on March 14th, 2016