The classic symptoms of acute appendicitis are pain in the epigastric or periumbilic area, accompanied by short-term nausea, vomiting and anorexia; After a few hours, the pain moves to the right lower quadrant of the abdomen. Pain is worse when coughing and moving.
Classical signs of appendicitis are localized directly in the right lower quadrant of the abdomen and at the point McBurney (point located outside 1/3 of the line connecting the navel and the anterior tip of the ilium), where pain is manifested when there is a sudden decrease in pressure during palpation (eg, a symptom Shchetkin-Blumberg).
Additional symptoms include pain that appears in the right lower quadrant when the left lower quadrant is palpated (sign of the roving), pain intensification with passive flexion in the right hip joint, in which the iliopsoas muscle contraction (psaas symptom) occurs, or the pain that occurs when passive internal rotation of the bent hip (obturator symptom). Usually subfebrile body temperature is observed [rectal temperature 37.7-38.3 ° C (100-101 ° F)].
Unfortunately, these classic signs are observed in just over 50% of patients. There are different variants of symptoms and signs.
Pain with appendicitis may not be localized, especially in infants and children. Soreness can be diffuse or, in rare cases, absent. The chair is usually rare or absent; In the case of diarrhea, the retrocecal location of the process should be suspected. Urine may contain red blood cells or leukocytes. Atypical symptomatology is common in elderly patients and pregnant women; in particular, pain and local soreness may be unexpressed.
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