discussion on Pediatric Appendicitis case.pptx

pediatric case

1. Kazakh Russian Medical University Pediatric Surgery Manan Gandhi Group – 402 A

2. Acute Appendicitis in children

3. Pathophysiology of Pediatric Appendicitis Appendicitis is thought to be due to obstruction of the appendiceal lumen with fecaliths , ingested foreign bodies, parasites, tumors , and/or lymphoid hyperplasia. This obstruction eventually leads to increased intraluminal pressure which causes lymphatic and venous congestion, impaired arterial perfusion, and finally ischemia and necrosis of the appendix leading to perforation.

4. Symptoms malaise and anorexia Periumbillical colic
Pain shifting to the right
iliac fossa
Nausea
Indigestion or subtle changes in bowel habits Diarrohea

5. Physical Signs and Examination Physical Signs Pyrexia
Localized tenderness in the right iliac fossa
Muscle guarding
Rebound tenderness Pointing sign Rovsing’s sign Psoas sign
Obturator sign

6. Rovsing sign

7. Diagnosis – Imaging And lab tests

8. Treatment And Management Correction of dehydration Correction of electrolytesManagement of pain
Antibiotic therapy The use of antibiotic for treatment of appendicitis is clearly beneficial
►For simple appendicitis
► Single preoperative dose to 24 hours of post operative antibiotic therapy Complicated appendicitis
A 10-day course of intravenous ampicillin, gentamicin, and clindamycin or metronidazole is the gold standard for the treatment of complicated appendicitis

9. Laparoscopic Appendectomy A laparoscopic (lap-a- ro - SKOPP- ik ) or “lap” appendectomy is a minimally invasive surgery to remove the appendix through several small incisions, rather than through one large one.

10. Laprotomy Laparotomy (open): A surgeon makes one larger incision in your child’s lower right abdomen. This type of appendectomy often is used in more complicated cases of appendicitis. It has a longer recovery time.

11. Thank you