Internal Medicine

P1: SBT

0521779407-04 CUNY1086/Karliner 0 521 77940 7 June 13, 2007 7:8

156 Appendicitis Arterial Embolus

■Appropriate for selected cases of appendiceal phlegmon, followed

by interval appendectomy

follow-up

■No specific follow-up needed

complications and prognosis

■Wound infection most common complication, esp if appendix gan-

grenous, perforated, or in presence of abscess

■Pelvic abscess more common w/ advanced appendicitis, may require

percutaneous drainage

■Small bowel obstruction may occur even years later after any laparo-

tomy

■Cecal fistula relatively uncommon; may be more common in Crohn

disease

Arterial Embolus.....................................

RAJABRATA SARKAR, MD

history & physical

Sources for arterial embolus

Most Common

■Atrial fibrillation

■Myocardial infarction within 6 weeks

■History of prior arterial embolus

Less Common

■Rheumatic heart disease

■Left ventricular aneurysm

■Prosthetic cardiac valve

■Endocarditis

■Dilated cardiomyopathy

■Atrial myxomas

■Aortic aneurysm

■Aortoiliac occlusive disease

■Paradoxical embolus (venous origin)

Signs & Symptoms

■5P’s

➣Pain