Appendicitis is the most common cause of abdominal pain requiring surgical intervention. It is usually caused by an obstruction of the appendiceal lumen due to fecaliths or lymphoid hyperplasia. Patients may experience sharp periumbilical pain that moves to the right lower quadrant, anorexia, nausea, vomiting, and low-grade fever.
There is typically exquisite right lower quadrant (RLQ) tenderness at McBurney’s point, located one-third of the distance from the anterior-superior iliac spine (ASIS) to the umbilicus.
Other signs that point to the diagnosis of acute appendicitis include:
Obturator sign: Pain with passive flexion and internal rotation of the right hip.
Psoas sign: Pain with passive extension of the right hip.
Rovsing’s sign: Referred pain to the right lower quadrant with palpation of the left lower quadrant.
Labs often demonstrate leukocytosis > 10,000/μL. Urinalysis may also demonstrate microscopic hematuria and pyuria.