Early on primarily malaise, indigestion, anorexia
Later patient develops abdominal pain
Initially vague, periumbilical (visceral innervation)
Later migrates to McBurney point (parietal innervation)
Nausea, with or with out emesis, typically follows onset of pain
Fever may or not occur
Urinary symptoms common given proximity of appendix to urinary tract (sterile pyuria)
Sudden improvement suggests perforation
33% of patients have atypical presentation
Retrocecal appendix can cause flank or pelvic pain
Gravid uterus sometimes displaces appendix superiorly → RUQ pain
Later patient develops abdominal pain
Initially vague, periumbilical (visceral innervation)
Later migrates to McBurney point (parietal innervation)
Initially vague, periumbilical (visceral innervation)
Later migrates to McBurney point (parietal innervation)
Retrocecal appendix can cause flank or pelvic pain
Gravid uterus sometimes displaces appendix superiorly → RUQ pain
Rovsing sign (palpation of LLQ worsens RLQ pain)
Psoas sign (extension of right leg at hip while patient lies on left side elicits abdominal pain)
Obturator sign (internal and external rotation of thigh at hip elicits pain
Peritonitis suggested by:
Right heel strike elicits pain
Guarding
Rebound
Rigidity
Right heel strike elicits pain
Guarding
Rebound
Rigidity
Appendicitis
Cervicitis
Perforated appendicitis
Uvulitis
Peritonitis
Orchitis
Abdominal aortic aneurysm
Diverticulitis