PAEA Surgery End Of Rotation (EOR) Practice Exam

If the appendix is retrocecal, what may happen during a rectal exam?

1. Increased heart rate

2. Abdominal distension

3. Often pain upon examination

4. Feeling of pressure in the bladder

The correct answer is: Often pain upon examination

In cases where the appendix is retrocecal, it is positioned behind the cecum, which can influence clinical findings during a rectal examination. When examining a patient with a retrocecal appendix, the anatomical localization of the appendix can lead to irritation of surrounding structures, particularly the peritoneum and pelvic organs. This irritation may manifest as increased sensitivity or pain when the area is palpated during a rectal exam. The rectal examination may trigger discomfort in the region of the retrocecal appendix, resulting in the patient reporting pain upon examination. This pain can reflect the inflammation associated with appendicitis, especially if the appendix is in close proximity to the rectum. Because the retrocecal appendix is somewhat shielded from direct palpation through the abdomen, the rectal examination can become a more effective method for eliciting signs of this condition, making pain upon examination a notable finding. In contrast, other options such as increased heart rate, abdominal distension, or a feeling of pressure in the bladder would not specifically relate to the presence of a retrocecal appendix during a rectal exam as directly as the pain might. These symptoms may be associated with other gastrointestinal or urological conditions and do not highlight the specific diagnostic implications of