Appendicular abscess physical examination: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Appendicular abscess}} | {{Appendicular abscess}} | ||
{{CMG}};{{AE}}{{ADG}} | {{CMG}}; {{AE}}{{ADG}} | ||
==Overview== | ==Overview== | ||
Physical examinations mostly focus on abdominal findings. The patient may appear | 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=== | ||
*[[ | *[[High fever|High grade fever]] | ||
*[[Tachycardia]] | *[[Tachycardia]] | ||
*[[Hypotension]](If its associated with rupture) | *[[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=== | ||
| Line 16: | Line 17: | ||
*[[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. | ||
*Characteristic signs of appendicitis may not be present in abscess. | *Characteristic signs of [[appendicitis]] may not be present in [[abscess]]. | ||
* [[Rebound tenderness]] | * [[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. | ||
| Line 33: | Line 45: | ||
| year = 2012 | | year = 2012 | ||
}}</ref> | }}</ref> | ||
* 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> | * 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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Appendicular abscess Microchapters |
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Appendicular abscess physical examination On the Web |
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American Roentgen Ray Society Images of Appendicular abscess physical examination |
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Risk calculators and risk factors for Appendicular abscess physical examination |
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
- High grade fever
- Tachycardia
- Hypotension(If its associated with rupture)
- Tachypnea [1]
Skin
Neck
- No masses
Cardiovascular system
- Regular rate and rhythm
- Normal S1, S2
- No murmurs, rubs, or gallops
Lungs
Bilateral normal vesicular breath sounds.
Abdomen
- The abdominal wall is very sensitive to mild palpation.
- Characteristic signs of appendicitis may not be present in abscess.
- 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.
- 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.[2]
- 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.[3]
Neurological
Alert, oriented X 3
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
- ↑ Appendicitis. Wikipedia (2016). https://en.wikipedia.org/wiki/Appendicitis Accessed on March 14th, 2016