Why Does Appendicitis Pain Shift to Right Lower Abdomen? | Dr. Umalakshmi Premnath

Pain around the navel that shifts to the right lower abdomen —
Do you know exactly WHY this happens?

In this high-yield surgery lecture, Dr. Umalakshmi Premnath explains Acute Appendicitis — from pathogenesis to complications, clinical signs, imaging findings and complete management!

⏱️ CHAPTERS
0:00 – Introduction to appendicitis
0:05 – Most common emergency surgical disease
0:13 – Positions of appendix & presentation
0:18 – Pelvic appendix symptoms
0:23 – Appendicitis in pregnancy
0:37 – Appendicitis in children — faecolith
0:44 – Complications overview
0:49 – Why inflammation happens
0:54 – Infective pathology & bacterial infection
1:08 – Faecolith causing obstruction
1:19 – Mucosal disintegrity & bacteria
1:23 – Bacterial invasion — lymph nodes & sepsis
1:33 – Simple vs complicated appendicitis
1:38 – Transmural necrosis explained
1:49 – Perforation → phlegmon → abscess → peritonitis
1:59 – Pile phlebitis — portal vein thrombosis
2:05 – Intrahepatic abscess
2:11 – Portal cavernoma — late complication
2:23 – Tumors of appendix
2:27 – Elderly appendicitis — rule out malignancy
2:40 – Normal appendix — Crohn's, diverticulitis, malignancy
3:01 – Age distribution & incidence
3:07 – 70% cases under 30 years
3:16 – Perforation — 20% of cases
3:27 – Gangrenous appendicitis
3:33 – Perforation mortality
3:38 – Higher risk extremes of age
3:44 – Causes of obstruction
3:50 – Bacteria → distension → vascular thrombosis
3:55 – Transmural necrosis → perforation
4:01 – Perforation at base vs tip
4:20 – Pathogenesis simple appendicitis
4:32 – Medical management — antibiotics
4:35 – Interval appendectomy — 6 weeks
4:47 – Phlegmon vs abscess management
4:57 – Gangrenous perforation — immediate surgery
5:13 – Pile phlebitis explained
5:18 – Portal vein → intrahepatic abscess
5:40 – Appendiculolith — 50% gangrenous cases
5:51 – PVF triad — Pain, Vomiting, Fever
5:56 – Why vomiting first = gastroenteritis
6:15 – Initial visceral pain — vague umbilical
6:23 – Shift to parietal pain — RIF
6:30 – McBurney's point — 12 to 24 hours
6:39 – Associated nausea, vomiting, fever
6:45 – Pelvic appendix — suprapubic symptoms
6:55 – Right upper quadrant pain in pregnancy
7:05 – Atypical presentations
7:16 – Children — small omentum, high perforation risk
7:24 – Elderly — minimal symptoms, late diagnosis
7:39 – McBurney's point — maximum tenderness
7:44 – Rovsing, Psoas, Obturator signs
7:51 – Peritoneal irritation signs
7:56 – Patient lies still — peritoneal inflammation
8:03 – Jiggling bed sign
8:10 – Rebound tenderness McBurney's
8:21 – Psoas sign — hip extension
8:31 – Obturator sign — internal rotation
8:41 – Scoring systems — Alvarado score
8:50 – Differential diagnosis — RLQ conditions
9:04 – Rectal & pelvic examination
9:14 – Children — challenging history
9:19 – Elderly — late diagnosis
9:24 – Lab tests — TLC, CRP, shift to left
9:31 – Other tests — rule out differentials
9:35 – Amylase lipase — exclude pancreatitis
9:42 – Pregnancy test & cervical cultures
9:49 – Stool occult blood — caecal malignancy
9:59 – X-ray findings — faecolith, air under diaphragm
10:05 – Ultrasound findings
10:21 – Wall thickening more than 4mm
10:33 – Periappendiceal fluid collection
10:38 – Appendix diameter more than 6mm
10:48 – USG findings summary
10:53 – CT scan findings
11:00 – Periappendiceal fat stranding
11:09 – CT findings summary
11:19 – When CT is preferred
11:31 – Dilated appendix on CT
11:36 – Faecolith on CT image

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💬 Comment — Did you know about portal cavernoma as a late complication of appendicitis?
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Видео Why Does Appendicitis Pain Shift to Right Lower Abdomen? | Dr. Umalakshmi Premnath канала Conceptual Medicine