Acute Appendicitis

Clinical Feature :

1)Sudden pain that begins on the right side of

the lower abdomen.

2)Sudden pain that begins around your navel and

often shifts to your lower right abdomen.

3)Pain that worsens if you cough, walk or make

other jarring movements.

4)Nausea and vomiting.

5)Loss of appetite.

6)Low-grade fever that may worsen as the illness progresses.

7)Constipation or diarrhea

8)Abdominal bloating

9)Flatulence

O /E:

1)McBurny's point Tenderness: positive 

2)Rovsing sign : positive 

3)Abdominal rigidity present

Investigations: 

Conservative Treatment:

• 1.Bed rest
• 2. Diet: NPO, TFO
  
• 3.NG Suction - 2 hourly
  
• 4.Continuous Catheterization

Medications:

1. Inf Hartsol ([post id="506" title="Hartmann"]) (2L)+5% DNS (1L)

• I/V@30 d/min

2. Inj. Ceftron([post id="398" title="Ceftriaxone"]) (1gm)

• 1 vial ...I/V..... BD

3. Inj. Filmet([post id="406" title="Metronidazole"]) (500mg/100ml)

• 1 bag/bottle... I/V .......TDS

4. Inj. Maxpro([post id="392" title="Esomeprazole"]) (40mg)

• 1 vial ........I/V ..........BD

5.Inj. Torax ([post id="450" title="Ketorolac"])(30mg)

• 1amp 1/M   ........stat& sos

if Severe pain

Inj.Nalbun-2([post id="457" title="Nalbuphine"])

1 ample .I/M .......stat

+(plus)

Inj. Vergon([post id="505" title="Prochlorperazine"] (12.5mg)

•  1 amp I/M- stat & sos

If Vomiting

Inj.Emistat([post id="509" title="ondansetron"])

• 1 ample I/V stat  & sos

6. Monitor vitals sign

7.Follow-up 

Pre-Operative Order:

1.Diet: NPO ,TFO

2. Inf. Hartman solution ([post id="506" title="Hartmann"])(1000ml)

• ……10-20 drop/min

3.Inj.Ceftron([post id="398" title="Ceftriaxone"]) (1gm)

• … 1 vial I/V ….stat

4. Inj.Sergel ([post id="392" title="Esomeprazole"])(40mg)

• …1 vial I/V stat

5.Inj.Rolac([post id="450" title="Ketorolac"]) (30mg)

• ….1 ample I/M OR I/V stat & SOS

6.Clean the operative area .

7.send the patient OT table 30 min before operation .

8. Counsel the patient party & written consent must be taken.

Post Operative Order:
1.Diet: NPO, TFO(Till further order)
2.Inf.Hartman ([post id="506" title="Hartmann"])(1L) +
Inf.5%DNS([post id="510" title="DNS"])(1L) +
Inf.5%DA ([post id="511" title="Dextrose "])(1L)

• ….I/V 30 drop/min.

3. Inj.Ceftron([post id="398" title="Ceftriaxone"])  (1gm)

• … 1 vial I/V ….BD 

4. Inj.Sergel ([post id="392" title="Esomeprazole"])((40mg)

• …1 vial I/V ….BD

5.Inj.Filmet([post id="406" title="Metronidazole"])(500mg/100ml)

• …1 bottle I/V….stat.& TDS

6.Inj.Rolac([post id="450" title="Ketorolac"]) (30mg)

• ….1 ample I/M OR I/V stat & TDS 

OR 
Inj.Anadol([post id="453" title="Tramadol"]) (100mg/2ml)

• ….1 ample I/M OR I/V stat & TDS

7.Nalbun-2( Nalbuphine)

• …1 ample I/M stat 

OR 
Inj.G-Pethidine([post id="456" title="Pethidine"](100mg/2ml)

• …..1 ample I/M stat

With 
Inj.Vergon( Prochlorperazine) (12.5mg/ml)

• …1 ample …I/M stat 

8.Voltaline ([post id="448" title="Diclofenac"])suppository (50mg)

• ….1 stick Per rectal –SOS

9.Monitor all Vitals…any abnormality then call doctor

Discharge Rx: (Outdoor)

 Discharge Treatment:

1.Cap.Denver([post id="399" title="Cefixime"]) (200mg)

• 1+0+1……...7 days

2. Tab.Fimet ([post id="406" title="Metronidazole"]) (400mg)

• 1+1+1………..5 days
  

3.Cap.sergel ([post id="392" title="Esomeprazole"]) (20mg)

• 1+0+1………..14 days
  

4.Tab.Rolac([post id="450" title="Ketorolac"])  (10mg)

• 1+0+1(after meal) ….5 days
  

5.Tab.Rivotril([post id="474" title="Clonazepam"]) (0.5mg)

• 0+0+1……..15 days
  

6.Tab.CEEVIT([post id="466" title="Ascorbic"] Acid)(250mg)

• 1+0+1……...10 days
  

7.Tab.Xinc-OT([post id="470" title="Zinc"])

• 1+0+1…………1 month

উপদেশঃ

• ১ মাস বিশ্রামেে থাকবেন। 
  
• ১ মাস কোন ভারী কাজ করবেন না। 
  
•  আমিষ জাতীয় খাবার কম খাবেন। 
  

❣️❣️নিরবতা এক ধরনের অলস্কার যা মহিলাদের জন্য অত্যন্ত শোভনীয়-হেনরীডেজন।❣️❣️

if  Constipation:

💊Syp.Avolac ([post id="515" title="Lactulose"])   3-4 Tsf ....TDS

Advice:  For Bangla [post id="513" title="Click"] 

1. Do not do any heavy work

for 2 months.
2. 15 days rest.
3. Cut the stitches after

the next.....day

OT Drug List: