Transcript Appendectomy pictures - Welcome! SURGERY

CASE: RLQ Pain
A 17 year old otherwise healthy female presents to the University Hospital
emergency department with a 12 hour history of fever and abdominal pain
followed by nausea and vomiting. At home the fever was 101. The
abdominal pain began in a periumbilical location but now localizes in the
right lower quadrant. The nausea and vomiting began 6 hours after the
onset of abdominal pain. The patient denies cough or dysuria. She has not
traveled out of the US. She denies consumption of contaminated food. She
has not changed her diet recently. She has had unprotected sexual activity
with multiple partners over the last few months. No family members are ill.
In the emergency department the vital signs are temp 100.7, P110, RR26,
and BP110/60. The lungs are clear. The heart has tachycardia but no
gallops, rubs or clicks. The abdomen has point tenderness in the right lower
quadrant and decreased bowel sounds. There is abdominal pain with
rotation of the right hip. The rectal examination shows mild right sided
tenderness but is guiac negative.
Slide 1 Radiographs of appendicitis
Slide 2 CT scans of appendicitis
Slide 3 Complications of appendicitis
Slide 4 Laparoscopic appendectomy
Slide 5 Pathology of appendicitis
Key for slides
Across page from top to bottom
• Slide 1 Radiographs of appendicitis-U/S of
inflamed appendix, upright abdominal
radiograph with fecolith, close up abdominal
radiograph with fecolith, free intraabdominal
perforation
• Slide 2 CT scans of appendicitis-inflamed
intraperitoneal appendix, another inflamed
appendix, inflamed retrocecal appendix,
inflamed appendix with fecolith
Key for slides
Across page from top to bottom
• Slide 3 Complications of appendicitis-hepatic
abscess, portal vein gas
• Slide 4 Laparoscopic appendectomy- suppurative
appendicitis, endoloop around appendix, cinched
endoloop around appendix, ligated and separated
appendiceal stump
• Slide 5 inflamed appendix, perforated appendix,
fecolith in appendix