Editing Appendicitis (section)

== '''Acute perforated appendicitis, or delayed presentation with diffuse peritonitis''' ==

* Emergency appendicectomy     after resuscitation
* Drainage/irrigation
* Probably doesn't need a drain
* Beware of wound infection -     use interrupted sutures, or consider delayed closure after two days
* Post-op antibiotics - total     of 5 days IV + oral - use tazocin/IV augmentin with a switch to PO     augmentin (or bactrim + metronidazole if allergic)
** Temp < 38 for 24 hours,      tolerating diet, mobilising, only PO analgaesia = downgrade to PO Abx
** Gangrenous appendicitis      without pus does not require much post-op ABx
* Ileus is very likely - start     low with diet and upgrade only as needed
* Will often need to stay in     hospital for 5-7 days until they tolerate regular diet