appendicitis modi

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