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If I’m not wrong, appendicectomy is the first surgical procedure which is taught to a future surgeon. So, it is important that the student or doctor must be able to diagnose the appendicitis. There are some signs which are picked up in a patient with appendicitis.
General signs:
(1) Pyrexia
(2) Tachycardia
(3) White or furred tongue
(4) Fetor oris (an offensive odor)
Local Signs:
(1) Pointing sign: Patient precisely localise the pain where it started and where to moved.
(2) Cough sign: Patient feels pain in right iliac fossa with cough impulse.
(3) Localized tenderness: When pain has been shifted to right iliac fossa it becomes localized at McBurney’s point.
(4) Muscle guarding and rigidity: Doctor can feel guarding and rigidity in right iliac fossa on palpation.
(5) Rebound tenderness: When hand is pressed and then released in right ilaic fossa the patient complains of pain.
(6) Rovsing’s sign: When left iliac fossa is pressed in patient with appendicitis, the patient feels pain in right iliac fossa.
(7) Psoas sign: In case of retrocaecal appendix, hyperextension of right hip causes pain in right iliac fossa. This is due to irritation of psoas muscle.
(8) Obturator sign: In case of pelvic appendix, the internal rotation of right hip causes pain in right iliac fossa. It is due to irritation of obturator muscle. (Last month, my friend suffered from appendicitis at night and passed the whole night in the emergency. However, he recovered his inflamed appendix and saved himself from undergoing operation of the inflamed appendix).