appendicitis modi

23
APPENDICITIS Clinical Surgery Department Dr. Benjamin Robles Madrigal Dr. Héctor Manuel Virgen Ayala Alumno Javier Cosío Cardenas

Upload: clinicas-quirurgicas

Post on 27-May-2015

623 views

Category:

Health & Medicine


8 download

DESCRIPTION

trabajo de clinica quirurgica

TRANSCRIPT

Page 1: Appendicitis modi

APPENDICITIS

Clinical Surgery DepartmentDr. Benjamin Robles Madrigal

Dr. Héctor Manuel Virgen AyalaAlumno Javier Cosío Cardenas

Page 2: Appendicitis modi

Anatomy and fisiology

the appendix is a diverticulo ovni in the iota of the blind approximately 2.5 cm below the ileocecal valve

Page 3: Appendicitis modi
Page 4: Appendicitis modi

Appendix acute

fibrous bands, Lymphoid Hyperplasia, fecalitos, calculations y parasites

the main cause is infectious

Page 5: Appendicitis modi

PHASE

Inflammatory edematous (invasion of the wall) suppurative (exudate and filtration) gangrenous (necrosis)Drilling (release 48Hrs in 80%)

Page 6: Appendicitis modi

Dx and Dx differential

ClinicLab (protein C. leucocitosis)USG

pelvica inflammatory disease and other ailments ginecologicos

Page 7: Appendicitis modi

Cx clinic

trouble half abdominal anorexia Nausea 50 -60 % mild colicos localized pain

Page 8: Appendicitis modi

Phisical exploration

sensitivity to palpation pain on the drums peristalsis normal or slightly reduced

temperature 37.8

Page 9: Appendicitis modi

AaronMc burneyPsoas Talopercusionrobsin

Page 10: Appendicitis modi

Appendicitis chronic

pain for three weeks fibrotico appendix,USG laparoscopy of preference, Rx with barium

Page 11: Appendicitis modi

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%

Page 12: Appendicitis modi

common errors in the diagnostic

digital rectal appendix retrocecal appendix in upper right quadrant discard an appendicitis situs inversus

Page 13: Appendicitis modi

drilling

Pain more severe fever 38.3 generalized peritonitis or abscess

Page 14: Appendicitis modi

peritonitis

sensivility, stiffness, abdominal distension, paralizad ileus

Page 15: Appendicitis modi

abscess

• discectomy ultrasound guided aspiration antibiotic and apendicectomia 6 weeks afteror apendicectomia immediate

Page 16: Appendicitis modi

pileflebitis

is a festering thrombophlebitis of the venous system portal

TAC thrombosis gas in the vein of portal

Page 17: Appendicitis modi

Rx

levels of air-liquid density +++ air free ---

Page 18: Appendicitis modi
Page 19: Appendicitis modi

TAC

further definition of the wall thickening enlarged less reliable findings

Page 20: Appendicitis modi

ultrasound

differentiation of abscess and phlegm pericecal

Page 21: Appendicitis modi

prevention

nothing

Page 22: Appendicitis modi

tx

Apendicectomia: laparoscopy or cut open. antibiotic abdominal drain

Page 23: Appendicitis modi

prognosis

index of death of. 1%, reduction of 5% replacement of liquids and a postoperative infection in 30% of cases