Typical clinical features

See Figure 30.10 . Typical clinical features are:

• maximum incidence 20-30 years

• initial pain is central abdominal (sometimes colicky)

• increasing severity and then continuous

• shifts and localises to RIF within 6 hours

• may be aggravated by walking (causing a limp) or coughing

• sudden anorexia

• nausea and vomiting a few hours after the pain starts localised R[F pain anorexia, nausea, vomiting £ u<j r: I i r g

First central abdominal pafn

(viserai pain)

Later

RiF pain [sornalsc pain) Mcfiurney's pûlnL

localised R[F pain anorexia, nausea, vomiting £ u<j r: I i r g

Fig. 30.10 Typical pain distribution of acute appendicitis
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