signs
Last reviewed 01/2018
Possible signs include:
- lying still, with shallow breaths and reluctant to cough
- tachycardia
- fever 37.5-38.5øC, worsening with perforation
- foetor oris - halitosis
- furred tongue
- flushed
- right iliac fossa signs:
- tenderness:
- dependent on position of viscus; localised tenderness per se is a more valuable sign than tenderness localised over McBurney's point
- not evident before later inflammation of serosa and parietal peritoneum
- often masked in obese due to inability to displace viscus
- rigidity:
- after the development of localised tenderness
- localised initially progressing to generalised with perforation or increasing peritonitis
- guarding
- rebound tenderness
- tender on the right per rectum
- a mass in the right iliac fossa is suggestive of abscess formation
- positive Rovsing's sign
- with retrocaecal appendicitis, possible positive:
- psoas sign
- obturator sign
- paraesthesia:
- occasionally reported in the distribution of T10-T12 on the right side
- test with light scratch with a sterile needle
Notes:
- a systematic review revealed that the most useful single feature for diagnosing appendicitis in children with abdominal pain was fever in unselected children and rebound tenderness in selected children (1)
Reference: