Anorectal abscess

Anal fissure

Grades of haemorrhoids (Piles)

Notes about Appendicitis from د. طارق الهوني

- Appendicitis patient can present to the hospital with either diarrhea, constipation or dysuria.
- as a complication of acute appendicitis ➡ ILEUS occur which is decrease in the intestinal motility and the patient present with #Constipation.
- the patient can present with diarrhea if the appendix position is pre-ileal ➡ the inflammation of the appendix will irritate the ileum, increasing its motility so will lead to #Diarrhea.
- the patient can present with dysuria if the appendix were in the pelvic position ➡ the inflammation of the appendix will irritate the urinary bladder and causes #Dysuria.
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- Diagnostic laparoscopy ➡ 100% accurate investigation for appendicitis.
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#Differential_diagnosis_of_the_case
- Appendicitis.
- Gastroenteritis ➡أكثر وحده ممكن يلخبطوا بينها و بين الappendicitis
- Crohn's disease.
- Rupture ovarian cyst.
- Pelvic inflammatory disease.
- Meckel's diverticulum ➡ can't diagnosed clinically needs diagnostic laparoscopy.
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#Some_Sign_Used_To_Diagonse_Appendicitis_Clinically

#Rovsing_Sign
if palpation of the left lower quadrant of a person's abdomen increases the pain felt in the right lower quadrant, the patient is said to have a positive Rovsing's sign and may have appendicitis.

#Rebound_Tenderness
Pain upon removal of pressure rather than application of pressure to the abdomen.

#Psoas_Sign
It indicates irritation to the iliopsoas group of hip flexors in the abdomen, and consequently indicates that the inflamed appendix is retrocaecal in position.

- More than 70% of appendix is retro-cecal.

- It has 2 maneuvers :

1. Flexion of the hip joint when the patient is laying in supine position.
2.put the patient in the left lateral position and extend the hip joint.

🚨if the patient felt any pain during the last 2 maneuvers we say that the Psoas sign is POSITIVE🚨

#Obturator_Sign
is an indicator of irritation to the obturator internus muscle "pelvic appendicitis"

Maneuver :
Put the patient in the left lateral position and do flexion & internal rotation of the hip joint.
- if the patient feel pain during the maneuver we say that the obturator sign is POSITIVE.

🚨 Site of appendix
- Retrocecal >> 74% Most common site "Psoas sign"
- Pelvic >> 21% 2nd Most common "Obturator sign"
- Post-ileal >> Most Dangerous "Portal venous thrombosis"

🚨 Most important signs in surgery 🚨

Surgery systematic revision cards

Content 📚📝

للناس لي تبي اتخصص أطفال الملف هذا ممكن يفيدكم لل OPD او في الأقسام، فيه جرعات الأدوية كيف مايكتبوا فيهن دكاترة MUB والأدوية الشراب مكتوب جنبهن كيف ينكتبن في الروشيتات لل OPD

10 حاجات تقدر تعملها لدعم فلسطين ؟!
#شخبطة

#مستشفي_المعمداني 🇵🇸

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