Hello and welcome to the Zero to Finals podcast. My name is Tom and in this episode I'm going to be

talking to you about appendicitis. And if you want to follow along with written notes on this topic,

you can follow along at zero definals.com slash appendicitis or in the gastroenterology section

of the Zero to Finals Pediatrics book. So let's get straight into it.

Appendicitis is inflammation of the appendix and the appendix is a small thin tube that sprouts from

the seacum. The appendix becomes inflamed due to infection trapped inside the appendix,

and it's trapped due to obstruction at the point where the appendix meets the bowel.

The inflammation can quickly proceed to gangrene and rupture.

The appendix can rupture and release fecal contents and infective material into the abdomen, and this leads

to peritonitis, which is inflammation of the peritoneal contents. The peak incidence of appendicitis

is in patients aged 10 to 20 years old. So what are the signs and symptoms? The key presenting

feature of appendicitis is abdominal pain.

This typically starts as central abdominal pain around the umbilicus that then moves down to the

right iliac fossa over time and eventually becomes localized in the right iliac fossa.

On palpation of the abdomen, there is tenderness at McBurney's Point,

and this is a localized area one-third the distance from the anterior superior iliac spine

to the umbilicus in the right iliac fossa.

The other classic features are loss of appetite or anorexia, nausea and vomiting,

Rovzing sign, which is palpation in the left iliac fossa causing pain in the right iliac

fossa, guarding on abdominal palpation, rebound tenderness, which is increased pain when quickly releasing the pressure on the right

iliac fossar. Percussion tenderness is pain and tenderness when percussing the abdomen. Rebound tenderness

and percussion tenderness suggest peritonitis, which will be caused by a ruptured appendix.

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