Examination of Acute Abdomen | Appendicitis-Signs & Symptoms | Surgeon Dr Imtiaz Hussain
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- Опубліковано 19 кві 2020
- How to approach a patient with Acute Appendicitis. What are signs & symptoms of acute appendicitis? What is Pointing Sign, Rovsing's sign, Psoas Sign, and Obturator Sign?
This video also explains ALVSRADO SCORE۔ What is MANTRELS.
M...Migratory Pain...1
A...Anorexia...1
N...Nausea...1
T...Tenderness...2
R...Rebound Tenderness...1
E...Elevated Temperature...1
L...Leucocytosis...2 (In video 1 has been written instead of 2)
S...Shift to Left...1
Total Score is 10.
If 1-4 score...Appendicitis is less likely.
If 5-6 score...Suspension of Appendicitis.
If 7-10 score...Appendicitis is definite.
You can get Appointment for operations in Lahore on following numbers:
03216303551 ( Whatapp messages only, no calls. 11:00am to 7:00pm)
::::: About Dr. Imtiaz Hussain :::::
Surgeon Dr. Imtiaz Hussain (Gold Medalist)
MBBS, Punjab, Pakistan.
FCPS, Pakistan.
AMC, Australia.
Associate FACS, USA.
LIFE MEMBERSHIP OF MEDICAL SOCIETIES:
1.Society of Surgeons of Pakistan(LC)-SSP
2. Surgical Oncology Society of Pakistan( SOS-PK)
3.Pakistan Academy of Family Physicians-PAFP® (Regd)
4. Public Relations Coordinator & Secretary of PAFP.
AWARDS & DISTINCTIONS:
Gold Medalist in Academics.
Surgical Jeopardy SURGICON 2011
Award of Excellence FAMILYCON®, 2019
PUBLICATIONS:
He has published his work in various medical journals.
ORGANIZER:
1.International Conference on Medical Education
2.International Conference on Family Medicine- FAMILYCON®.
Dr Imtiaz Hussain is a Consultant General and Laparoscopic Surgeon. After graduating from Nishtar Medical University, Pakistan, he visited Australia for the Australian Medical Council exam. He completed his FCPS degree which is the highest degree in Pakistan in the field of General Surgery. During his postgraduate residency program, he had also trained himself in the field of Urology, Plastic Surgery, Paediatric Surgery and Orthopaedic Surgery.
Since 2012, he, as a volunteer, is working as an instructor for the Basic Life Support (BLS) Program at Fatima Jinnah Medical University Lahore, Pakistan. In this course, he is the Master Trainer and teaches CPR and other lifesaving techniques to Doctors, Medical Students, Nurses, and Paramedical staff.
Since 2015, he is working as a Clinical Exam Coordinator for the examination of FCPS part 2 ( Clinical Exam) by the College of Physicians and Surgeons Pakistan (CPSP).
He has also served as an in-charge of Temporary Hospital set up by the Government of Pakistan in PC Hotel Lahore for Pakistan Super League (PSL) matches and also for the matches against the Zimbabwe cricket team.
He is a visiting consultant General & Laparoscopic Surgeon in various well-known hospitals of Pakistan.
::: TEAM MEMBER :::
Engineer ISHFAQ HUSSAIN
BSc electrical engineering, UET, Lahore, Pakistan.
M.E. Comm. & Info. Systems Engineering, Nanjing, China.
Special interest in software and mobile applications and video editing.
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Surgery vlogs, Clinical Examinations, Stepwise surgical procedures, Patients' point of view, and Publicl Awareness are salient features of this channel.
Channel keeps on posting SURGERY VIDEOS (STEPWISE PROCEDURES) of different surgical problems of various specialties for medical students, doctors and junior surgeons. These surgeries are exactly explained stepwise according to the textbook of surgeries and videos are made after collaborating with concerned specialty surgeons.
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Different CLINICAL EXAMINATIONS have also been shown in a separate playlist for medical students, doctors, and junior surgeons who are preparing for their upcoming exams.
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Lahore mein check up aur operation ya phr online consultation kliay hum say whatsapp number (+923216303551) par sirf message kar kay rabta karein.(No messages or call between 9pm to 7am). Hmara whatsapp number hmari har video ki description mein diya gaya hai but sirf whatsapp messages kar kay rabta karein. Call bilkul nahin karni plz. Yaad karwany kliay Miss call bhi na karein. Hum free ho kar bari bari har messages ka reply krty hain.
This is amazing... Even non doctors can easily understand this examinations. Simply awesome!
It is one of the best videos I encountered during these days.... It made my day!
Thanks a lot sir!
Thanks.I have started new series of Clinical Examinations. This may be beneficial for medical students as well as Doctors who Are Going to Appear in their Clinical Exams
Awesome, very simply elobrated, even after many years I am able to revise due to this video😊😍
Great and useful video from the point of practice and clinical examination.
Ap ki video boht zida informative hoti hy this video is very informative for me
very Nice sir even simple and layman can easily understand
It's long video as usual but very interesting and never divert the attention of audiences.
Excellent 👌 content and elaboration
Keep it up 👍
Thanks a lot😊😊
Thanks sir g for this video 😘 Shaban ho sir g
You best surgeon.
Thank you very much sir
video is infromative but one advice kindly do not put music .
Appreciate your concern. We try not to put music while content is being discussed or explained.
Informative video
Nice description
I m also one of ur student,I want and I wish to have speed like you Have while performing Surgrey....
Very helpful for clinical
Thanks for the feedback
Thanks a lot dr sir, really so sweet videos, love from India 🥰🎉
Most welcome!
Extremely useful video ❤❤
Glad you think so!
Great video to learn acute abdomen from!
Glad you liked it!
Very nice videos, please sir make more videos on examination according to guidelines with ruling out other differentials of the presenting complain
I have to appear for amc clinical so your videos shall be helpful
Very soon IA
Sir I am 998th subscriber of your channel
Done.
Good video for trainees
Thanks a lot
Very good n informative, I have few queries,
1 . Please also elaborate how to explain the whole examination in some precise words,
2. Should we have not done auscultation
3. Would have been more helpful if actual patient examined, because as you led the examinee to certain symptoms,
v nice video keep it up sir
Thanks for watching. Please keep sharing with friends who could benefit.
Good one sir.. Also include abdominal examination and general physical examination in the beginning especially pulse
InshAllah!
We have started this series and new videos of clinical examination will be added from time to time.
Subscribe and press bell icon so that we will send you the moment we upload new video and you couldn't miss it.
Also share our channel link with your friends' circle.
@@drimtiazhussain OK sir zror
Sir what about markle and dunphy sign? 😉
Any how Great way of explanation Sir, you made learning appendicitis a piece of cake , keep sharing the great knowledge 👍
Thanks for your valuable comments.
Markle and Dunphy signs are also elicited in Acute Appendicitis patient. In Dunphy Sign, patient feels abdominal pain on coughing and in Markle sign, patient feel pain in right iliac fossa on jarring due to acute appendicitis. Thanks for pointing out for audience.
sir.....ultrasound report shows 5.5mm appendix.....do we need to go for surgery ???
Please reply sir.....because my father is suffering form worsening pain
He has abdominal Tuberculosis also.....
What should we do sir ??
Well explained 👍
Thanks a lot for feedback
Hii Sir
Apendix Can we find through altra sound or not plz let me know
Sir its best👌
Thanks for watching. Keep watching and share with your friends. It may be very useful.
Subscribe and press bell button to our channel so that we may send you new videos every time we launch about examination.
Good One sir
Thanks and keep watching and sharing with your friends
Thanks Doc saab
Thanks
Obturator sign , appendicitis ko confirm krne ke liye hai , ruled out krne ke liye nhi 7.50
Nice and good sir g
Thanks. Keep watching and sharing with your friends and patients and doctors.
Good work
Thanks for the feedback.
Please make more videos on clinical examination
Yes. We will!
Good work Sir👍
Thanks. You watched it
Yes v good work for students indeed
What is "CHARPAI SIGN"?
Dr saheb ctscan with Iv contrast and oral kiya tha December 2023mein aur April 2024 mein sonography aur blood test Kiya .ye lower right mein dard tha teen saal se lekin report me cystitis aaya tha tab .
Agar aapne CT scan with oral aur IV contrast aur sonography karwayi aur sirf cystitis diagnose hui hai, jabke appendix ka koi problem nahi aaya, to pain in the right lower abdomen aur symptoms ko cystitis ya kisi aur underlying condition se relate kiya ja sakta hai.
### Understanding Cystitis:
**Cystitis** ek urinary bladder ki inflammation hai, jo ke:
- **Symptoms**: Painful urination, frequency, urgency, lower abdominal pain, aur sometimes nausea cause kar sakta hai.
- **Diagnosis**: Usually urine tests, and imaging tests (like CT scan) se diagnose hota hai.
### Other Possible Causes for Pain:
1. **Cystitis Symptoms**: Cystitis ki wajah se bhi right lower abdomen mein pain aur discomfort ho sakta hai, jo ke bladder ki irritation ki wajah se ho sakta hai.
2. **Pelvic Floor Dysfunction**: Pelvic floor muscle issues bhi similar symptoms cause kar sakte hain.
3. **Gastrointestinal Issues**: Jaise ke irritable bowel syndrome (IBS), constipation, ya gas issues.
4. **Ovarian Issues**: Female patients ke liye, ovarian cysts ya other reproductive issues bhi pain cause kar sakte hain.
5. **Muscular Strain**: Abdominal muscles ke strain ya injury bhi pain aur discomfort ka sabab ban sakte hain.
### Steps to Take:
1. **Follow-Up with a Specialist**: Urologist ya gastroenterologist se consult karen jo aapke symptoms ka detailed evaluation kar sakte hain aur further diagnosis aur treatment recommend kar sakte hain.
2. **Review of Treatment**: Cystitis ke treatment options jaise antibiotics, hydration, aur bladder care follow karen.
3. **Symptom Management**: Pain relief aur discomfort ke liye over-the-counter pain relievers (as advised by your doctor) use kar sakte hain.
4. **Lifestyle Adjustments**: High-fiber diet, adequate hydration, aur bladder irritants se bachne ki koshish karen.
Agar symptoms persistent hain aur aapko improvement nahi mil rahi, to additional diagnostic tests ya second opinion ki zaroorat ho sakti hai. Always discuss your concerns and symptoms in detail with your healthcare provider for accurate diagnosis and treatment.
Carry on boss
Alhamdulillah! We will continue this series InshaAllah.😊
Good job
Thanks for the feedback.
Sir,kindly explain difference btw guarding and rigidity,and how do we differentiate clinically???
Guarding is subjective while Rigidity is objective.
Guarding is shown by subject(patient) when RIF is palpated in order to protect himself from pain. Patient guards and make voluntarily his abdominal muscle tense.
While in Rigidity, patient's abdominal muscles become rigid and goes into spasm beacuse inflammed appendix irritates abdominal muscle. Muscles' spasm is not in control of patient.
Clinically, how do we differentiate? In guarding, while doing palpation, patient's muscles will contract at the time of touching to abdomen, and in spasm muscles will already be contracted and tight phase. Hope you understand them.
@@drimtiazhussain Thankyou sir.
For abdo examination flexion at knee joint is necessary to relax abdo muscles !
You are right. It assists
Nyc video
Thanks! Keep sharing.
Great...isse acha koi guide n kr skta
Shukriya
Quite helpful 🤠
Glad it helped
@@drimtiazhussain thank you so much sir for such amazing explanation
Thanks for the feedback
Sir mjhy lower and upper side abdominal pain h feel like gas.. lekn mjhy vomiting or fever kuxh nhi h na hi hilny julny sy pain hota or yeh mjhy 3 months sy hai lekn jab washroom hota hun to aram milta h or mjjy constipation bhi h..kindly bta dy kia problem h
You need proper examination from surgeon.
Lower right upper middle mein pain rehta hai appendicitis hai ta nahi confirm karne k liye kaunsi test karwani chahiye
Agar aap ko pait ke nichle dayen, ooper ya darmiyani hisse mein dard hai aur aap ko shak hai ke yeh appendix ka dard ho sakta hai, to iski tashkhees ke liye chand aham test aur moayine karwaye ja sakte hain:
### Mumkin Test aur Moayine:
1. **Physical Examination:**
- Doctor aap ka physical moaina karega, khaas tor par pait ke us hisse ka jo dard ka sabab ban raha hai. Woh appendix ki alamat ki jaanch karne ke liye mukhtalif dabao points par dabao dal sakte hain.
2. **Blood Test (CBC):**
- Khoon ka mukammal test (CBC) kiya ja sakta hai taake jism mein infection ya soozish ki mojoodgi ka pata lagaya ja sake. Agar white blood cells ki tadaad zyada ho to yeh infection ki nishandahi kar sakta hai.
3. **Ultrasound:**
- Appendix ke masail ki tashkhees ke liye ultrasound istemal kiya ja sakta hai. Yeh khaas tor par bachon aur hamil aurton mein mufeed hota hai.
4. **CT Scan:**
- Appendix ki tashkhees ke liye sab se zyada moasar test CT scan hai. Yeh aap ke pait ke andar ki tafseeli tasveerein faraham karta hai aur appendix ki soozish ya doosre masail ko wazeh tor par dikha sakta hai.
5. **Urine Test:**
- Peshab ke test ke zariye peshab ki naali ke infection ya gurday ke pathar jese masail ko mustarad kiya ja sakta hai jo pait ke dard ka sabab ban sakte hain.
6. **MRI:**
- MRI appendix ki soozish ki tashkhees mein bhi madadgar sabit ho sakta hai, khaas tor par aise mareezon mein jo CT scan ke liye mozoon na hon.
### Kholasa:
Appendix ke dard ki tashkhees ke liye physical examination, blood test, ultrasound, CT scan, urine test aur MRI jese mukhtalif test kiye ja sakte hain. Apne doctor se mashwara karen taake woh aap ke alamat ke mutabiq sab se mozoon test tajweez kar sakein.
Allah aap ko sehat de aur aap ki takleef door kare.
Sir, I have IBD and Yesterday I got my whole abdomen CT scan report... where it was mentioned that "No gut-related mass lesion seen.Long tortuous appendix noted,retaining
oral contrast in 24 hour delayed slices-may be due to recurrent
appendicular pathology in appropriate clinical setting."
But I don't have such Symptoms like your patient have. I Don't understand If I have appendicitis..
You should have check up from surgeon
nice
Thanks!
Nice
Thanks
What is left shift? Can you elaborate it? Why it is called "shift to left"?
Please refer to comments below. There has been full discussion on it with viewer Noor Javed. Thanks
@@drimtiazhussain Okay, I got that. Thanks!
We have our assessment tomorrow at S1 unit at ganga ram ... Sir Shabbir and sir Faisal are going to take our assessment 😂
Best of luck
Dr sahib ap ka address keya ha ka may apny moinay kaly woha ajawo our ap sy allaj karwa sakon
Ap kahan say hain?
May I know why gloves is wore as not in OT ? Thanks
Because we were touching patient
@@drimtiazhussain is the patient dirty or got germ on his body ? Thanks
These are examination gloves and are used while doing examination. It's a protocol so that hospital acquired infection should not cross either side.
Sir.....can appendix happen due to tuberculosis
Tuberculosis of last part of small intestine can confuse with symptoms of appendicitis but both are different things.
@@drimtiazhussain sir.....ultrasound report shows 5.5mm appendix.....do we need to go for surgery ???
Please reply sir.....because my father is suffering form worsening pain
Can appendix make nly lower right side back pain
Mostly!
In children can be in upper right side of abdomen and also in pregnant ladies
@@drimtiazhussain dan it pain also lower right abdomen
@@drimtiazhussain sir pls gv ur ph number
@@tolemchang7403 Yes but in females its pain is also confused with right ovarian cyst pain.
Sir mujhy b 5 din sy hai pain isi jagha py
Kisi general surgeon say check up karwaein fouran.
Background music ki disturb krti hai
Yeh porani video hai aur ab new videos mein aisa nahin
Sir kindly dont add background music and use collar mic
This was our old video. Now we are using mic in new videos. Thanks for the suggestion
R u ms surgeon or gyneac🤔
is this patient alive? did he need surgery? whether he had more tests if he had stomach pain?
He is fine and alive and living his normal life
Hernia surgry cost
More or less 35K
Asalam-0-Alikum sir bat sunY zara
Wslam!
Sunaein baat!
@@drimtiazhussain sir asla me ek peshnt aye Hain ultrasound krwany tOh usko right side pain hain to kia masla ho sakhta
@@sheezaRajputt4264 Appendix ka pain ho sakta hai, UTI ka pain, female mein Ovary ka masla bhi ho sakta hai. Kisi doctor ko dikhein wo examination kar kay final karay ga
@@drimtiazhussain chalen thk hai phir
Very good and handsome looking patient 🤭
Yes indeed
English please
بیک سائیڈ میوزک بہت برا لگتا ہے دماغ میں درد ہو تا ہے
Ye purani video hai
Sir,What is shift to left??
Excellent Question.
This couldn't be explained that's why it was left for those who will ask questions!
Coming to your questions.
As acute process is going on that's why inflammatory cells starts regenerating their new cells. These are actually immature new neutrophils and are mutinucleated.
(Left side)Immature NeutrophilsMature Neutrophils(Right Side).
As Immature neutrophils are high in blood circulation so, shift to left become evident.
This is one of diagnistic criteria of Acute (Inflammatory) Appendicitis.
@@drimtiazhussain Sir,Why immature neutrophils are high in blood?Why not mature neutrophils???
@@Noor123195 Because, it takes time for new cells to become mature and child takes time to become teen or youg adult but production of cells is too high that they start spilling into circulation from bone marrow.
@@drimtiazhussain Sir,you mean that the demand of neutrophils is increased by body,so they start entering the infection site(before getting matured.
You are right because of infection production is increased
wrong examination,,,, intrenal rotation means this?😂
Boht chhi video hai
Shukriya!
Isi trah video dekhti rahein aur share karti rahein