Acute Appendicitis

Posted on January 11, 2009
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What is acute appendicitis?
Acute appendicitis is an inflammation of the cecal appendix. Or cecal appendix vermiform appendix as its name suggests is a worm-shaped structure that results from the first portion of the large intestine. Its size is variable, about 10 centimeters and is located in the lower abdomen. The appendix is a channel in its interior that communicates with the large intestine where feces semifluidas. Acute appendicitis is caused in most cases, usually by a fossilized feces (fecalito) that obstructs the appendiceal channel. Acute appendicitis is the most common cause of acute abdominal pain and its treatment is surgical and emergency. As mentioned above a pre disponente is obstruction of the light from the adjacent organ, sometimes by a fecalito (fossilized feces), but the obstruction is not in all cases. In some cases the inflammation can be sourced locally or often unknown, although in some cases was found obstructed by a foreign body, among them are: fruit seeds, parasites. What the patient manifests symptoms?

The symptoms are:
Periumbilical abdominal pain that is diffuse or a little more to the stomach area, which later becomes localized to the right iliac fossa pain then gradually increases Nausea and vomiting. In some cases it appears if the fever and then ends in a peritonitis appendicitis in some patients appears high fever. (In the routine clinical assessment of symptoms can vary from patient) How to make the diagnosis of acute appendicitis?

This disorder is mainly based on clinical diagnosis, the doctor makes the patient’s physical examination (signs of Mc Burney Blumberg or positive), other relevant data that help us to diagnose the taking of a blood Biometría showing (leukocytosis of 10,000 to 15,000 leuc/mm3 and normal urinary tract examination (to rule out a possible infection and the differential diagnosis).

What can happen if left to evolve an acute appendicitis?
The most frequent complication is that the wall of the appendix is necrosa (gangrenous appendicitis), causing a perforation, with consequent generalized peritonitis, or in some cases the adjacent bowel loops are affected in such a way that causes perforation of the small intestine.

Another complication is the possibility that the omentum can join restricting peritonitis in the right iliac fossa. Fibrosis and inflammation produce a persistent right iliac fossa mass (mass apendicial). This can be solved through healing by formation of an abscess to drain to the surface or by drilling with generalized peritonitis.

A rare complication but should not be let pass over the spread of the infection by the branches of the portal vein that can spread to the liver before it was a major cause of abscesses in the liver piémicos portals.

What is the management of peritonitis?
Peritonitis is a more serious, the treatment is handled as intrahospital requires more days of observation, drains, and large quantities of antibiotics. Some patients with sepsis and peritonitis can die making (the numbers have declined due to the amount of antibiotics currently managed and effective management of this disease) What is the treatment of appendicitis water?
The management of this condition is the only apendicetomía (removal of the appendix). In which the preoperative patient is hydrated and get some antibiotics and painkillers.
Note: a major medical error is to consult a patient with pain in the right iliac fossa or generalized abdominal pain, is to give as they can mask pain to end up in acute appendicitis and peritonitis. You can take the decision by a physician with broad knowledge and experience in pathology, discarding the diagnosis of this problem before.


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