English

1era parte….

A 30 year old female began about five hours ago with discomfort in epigastric cramps-like that lasted two hours then of this pain was located in right iliac fossa
Thepatient was suffering nausea, vomiting and fever.
For five days before the patient reported had have similar episodes but less intense in right iliac fossa that relieved with rest.
On thephysical examination we found abdominal defense to the palpation, pain and peritoneal irritation sign, Blumberg (+) positive; McBurney's point (+).

2da parte
Possible diagnosis
-Cholecystitis
- Appendicitis
- Pancreatitis

Appendicitis causes
There is no clear cause of appendicitis.
Fecal material is thought to be one possible obstructing object. 
Bacteria,viruses, fungi, and parasites can be responsible agents of an infection that leads to swelling of the tissues of the appendix wall
Also, inflammatory bowel diseases 

3era parte
Symptoms andsigns
Appendicitis typically begins with a vague pain in the middle of the abdomen often near the navel or "belly button" (umbilicus). 
The pain slowly moves to the right lower abdomen(toward the right hip) over the next 24 hours. 
In the classic description, abdominal pain may be accompanied by nausea, vomiting, lack of appetite, and fever. 
All of these symptoms, however,occur in fewer than half of people who develop appendicitis. 
More commonly, people with appendicitis have any combination of these symptoms.

4ta parte
Treatment 
It’s importantdon't take (or give a child) laxatives, antibiotics, or pain medications because these may cause delay in diagnosis that increases the risk of rupture of the appendix or mask the symptoms, whichmakes diagnosis more difficult.
The best treatment for appendicitis requires surgery to remove the appendix (appendectomy)
While awaiting surgery, you will be given IV fluids to keep hydrated.