-
MC bacteria isolated in perforated appendicitis?
Bacteroides fragilis (80%) > E. coli (77%)
-
Dunphy’s signQ?
Pain on coughingQ
-
Rovsing’s signQ?
Pain in the right lower quadrant during palpation of the left lower quadrantQ
-
Obturator signQ?
- Pain on internal rotation of the hipQ
- Suggestive of pelvic appendixQ
-
Iliopsoas signQ?
- Pain on extension of the right hipQ
- Suggestive of retrocecal appendixQ
-
Characteristic findings of acute appendicitis?
Appendix ≥ 7 mm diameter, a thick-walled, noncompressible luminal structure seen in cross section (target lesion), or the presence of an appendicolithQ
-
Risk Factors for Appendicular Perforation?
- [@ Fecolith DIE in Pelvic Surgery]
- • FecolithQ
- • Diabetes mellitusQ
- • ImmunosuppressionQ
- • Extremes of agesQ
- • Pelvic appendixQ
- • Previous abdominal surgeryQ
-
What is Bastedo sign?
- • An obsolete sign in chronic appendicitisQ
- • Pain and tenderness in right iliac fossa on inflation of the colon with airQ
-
Alvarado Scores for acute appendicitis?
- 9–10 - Appendicitis is certain
- 7–8 - High likelihood of appendicitis
- 5–6 - Equivocal
- 1–4 - Appendicitis can be ruled out
-
Causative organism for acute mesenteric lymphadenitis?
Yersinia enterocolitica
-
Treatment of acute appendicitis in pregnancy?
- Early appendectomyQ is the appropriate therapy in suspected appendicitis during all stages of pregnancy.
- Laparoscopic appendectomy is safeQ
-
What is Alder’s Test?
- • Localizing the area of maximal abdominal tenderness and maintaining constant pressure on that point while the patient is being turned to leftQ.
- • If the pain is constant, pain is of extra-uterine origin; if pain disappears it is more likely to be uterine or tubal originQ.
- • This is a very useful and important clinical test which may be employed in all cases of an acute abdomen in pregnancyQ
-
Criteria for stopping conservative treatment of an appendix mass?
- • A rising pulse rateQ
- • Increasing or spreading abdominal painQ
- • Increasing size of the massQ
-
• MC neoplasm of appendix?
(MAC): Mucinous adenocarcinomaQ (38%) > Adenocarcinoma (26%) > Carcinoid (17%).
-
MC malignant neoplasms of the small bowel?
Carcinoid tumorsQ > adenocarcinomas > malignant GISTs > lympho
-
Gross appearance of Appendiceal Carcinoid?
Firm, yellow, bulbar mass in the appendix, majority are located in tip of appendix
-
Treatment of Appendiceal Carcinoid?
- Up to 1 cm• AppendectomyQ
- > 1–2 cm
- • Appendectomy if located at tip or mid-appendix
- • Right hemicolectomy if: −−Located at baseQ−−Invading mesoappendixQ −−LN involvementQ
- > 2 cm• Right hemicolectomyQ
-
Treatment of Mucocele appendix?
- Every effort is made to keep the mucocele intact during extraction, including placing the specimen in a bag or converting a laparoscopic procedure to an open procedureQ, if necessary.
- Appendectomy + Wide resection of the mesoappendix to include all the appendiceal lymph nodes + Collection and cytologic examination of all intraperitoneal mucus + Inspection of the base of the appendixQ.
- Right hemicolectomy is reserved for patients with a positive margin at the base of the appendix or positive periappendiceal lymph nodesQ.
-
Treatment of appendiceal adenocarcinoma?
Right hemicolectomy
-
Difference between McArthurQ and Rutherford incision?
- McArthur – No muscle incision
- Rutherford Morison - incisionQ by cutting the internal oblique and transversus muscles.
- In McBurney’s incision, incision is extended upwards and laterally, not downwards.
-
Prevention of Stump Appendicitis?
Residual appendiceal stump should not be more than 3mmQ
-
Which nerve is responsible for inguinal hernia after appendectomy?
IH → IH (IlioHypogastric nerve → Inguinal Hernia
-
What is Mitrofanoff procedurQ?
Urologic reconstruction as an appedicovesicostomy in patients requiring chronic catheterization for bladder emptying
-
What is Malone ProcedureQ?
Conduit for decompression after colon surgery or for the chronic administration of medications or enema
|
|
