acute appendicitis1

 female/32 year old/kedayan


passion come to E&T Department with complain :

Right iliac fossa region pain and radiated to epigastrium region continuously sine 4 day ago
also with fever low grad

•   nausea
•  loss watery stool 
• dysuria

blood pressure 190/108mmHg
pulse     109/min
temperature 37.5 C

condition in pain / pale

past medical/surgical history - nil

on examination
Abdomen -

•  tender at RIF region
•  rebound tenderness positive 
• macburnny  positive  
• soft
• distended 
• bowel sound sluggish

                  
plain 

• put in IV drep normal saline 1 pin for keep vain open 
• investigation  FBC/BUSE/BFMP/cretinin/UFEME/UPT
• FBC:220/115/337  BUSE: 133/3.54/98/_/130  UFEME: blood + /proten 3+
• nil by mouth
• Tab. nefedipine 10mg stat
• IV.renitidine 500mg stat
• IV. cefuoroxime 1.5 G stat
• IV. Metronidazole 500mg stat
• transfer to QEH hospital