Transcript
APPENDICITIS
Clinical Surgery DepartmentDr. Benjamin Robles Madrigal
Dr. Héctor Manuel Virgen AyalaAlumno Javier Cosío Cardenas
Anatomy and fisiology
the appendix is a diverticulo ovni in the iota of the blind approximately 2.5 cm below the ileocecal valve
Appendix acute
fibrous bands, Lymphoid Hyperplasia, fecalitos, calculations y parasites
the main cause is infectious
PHASE
Inflammatory edematous (invasion of the wall) suppurative (exudate and filtration) gangrenous (necrosis)Drilling (release 48Hrs in 80%)
Dx and Dx differential
ClinicLab (protein C. leucocitosis)USG
pelvica inflammatory disease and other ailments ginecologicos
Cx clinic
trouble half abdominal anorexia Nausea 50 -60 % mild colicos localized pain
Phisical exploration
sensitivity to palpation pain on the drums peristalsis normal or slightly reduced
temperature 37.8
AaronMc burneyPsoas Talopercusionrobsin
Appendicitis chronic
pain for three weeks fibrotico appendix,USG laparoscopy of preference, Rx with barium
Appendicitis and pregnancy
fever less common, typical Leukocytosis, most early the drilling, diffuse peritonitis in less time
apendicectomia, pneumoperitoneum, death has been reduced in women .5% and foetus 10%
common errors in the diagnostic
digital rectal appendix retrocecal appendix in upper right quadrant discard an appendicitis situs inversus
drilling
Pain more severe fever 38.3 generalized peritonitis or abscess
peritonitis
sensivility, stiffness, abdominal distension, paralizad ileus
abscess
• discectomy ultrasound guided aspiration antibiotic and apendicectomia 6 weeks afteror apendicectomia immediate
pileflebitis
is a festering thrombophlebitis of the venous system portal
TAC thrombosis gas in the vein of portal
Rx
levels of air-liquid density +++ air free ---
TAC
further definition of the wall thickening enlarged less reliable findings
ultrasound
differentiation of abscess and phlegm pericecal
prevention
nothing
tx
Apendicectomia: laparoscopy or cut open. antibiotic abdominal drain
prognosis
index of death of. 1%, reduction of 5% replacement of liquids and a postoperative infection in 30% of cases
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