Acute appendicitis: clinical manifestations, classification, surgical treatment, complications

Explain the clinical manifestations of acute appendicitis

Abdominal pain: the first symptom, initially localized to the periumbilical region, persistent aggravation, gradually shifts and fixed in the right lower abdomen
Gastrointestinal symptoms: nausea, vomiting, increased frequency of bowel movements
Systemic reactions: fever, lack or loss of appetite, oliguria, thirst, toxic symptoms.
Signs:
1. Rebound tenderness, pain on percussion, rigidity, and guarding, McBurney point tenderness: Most specific finding
2. RLQ tenderness but nonspecific
3. Left lower quadrant (LLQ) tenderness
4. Rovsing sign (RLQ pain with palpation of the LLQ): Suggests peritoneal irritation
5. Dunphy sign (sharp pain in the RLQ elicited by a voluntary cough): Suggests localized peritonitis
6. Psoas sign (RLQ pain with extension of the right hip or with flexion of the right hip against resistance): Suggests that an inflamed appendix is located along the course of the right psoas muscle
Laboratory tests: WBC is elevated and urine is normal.
Other checks: X-ray, B-ultrasound

Gastric duodenal ulcer perforation
Right ureteral stones
Gynecological diseases: ectopic pregnancy, ovarian follicular or Corpus luteum cyst rupture, acute salpingitis and acute pelvic inflammatory disease
Acute mesenteric lymphadenitis

* Acute salpingitis is infection of the fallopian tubes.

** Ruptured corpus luteal cysts are one of the commonest causes of spontaneous haemoperitoneum in a woman of reproductive age.

Incision infection
Peritonitis, abdominal abscess
Bleeding
Fecal fistula = one between the colon and the external surface of the body, discharging feces.
Appendiceal stump inflammation = Stump appendicitis refers to inflammation of the residual appendiceal tissue post appendectomy.
Adhesive intestinal obstruction