Acute Appendicitis

Classical triad of symptoms

Pain, vomiting and fever (Murphy’s triad) may not always be present. Pain shifts from around the umbilicus to the right iliac fossa with or without a positive Rovsing’s sign.

Classical sign of acute appendicitis

It is tenderness in McBurney’s point. Major conditions to be differentiated: These are iliac adenitis (usually with high fever and psoas spasm), pyelonephritis, pelvic infection and amoebic typhlitis.

Management

1. If the patient reports early before formation of a mass, advice emergency appendicectomy.
2. If presents with a mass, especially after 48 hours, the patient is put on Oschner-Scherren regimen.
3. If, on conservative management, the general condition worsens, it is likely that he has developed an appendicular abscess. Emergency drainage of abscess is indicated.4. If the infection gets controlled, advice interval appendicectomy after 6-8 weeks.