Clinical diagnosis and treatment of acute appendic

ncycgdxhl · Wysłany: Pią 23:26, 11 Mar 2011

Clinical diagnosis and treatment of acute appendicitis

Basic pathological conditions and consistent with literature reports. We are based on postoperative pathology report and literature have knowledge of the disease before. Summary of 5 patients in this group found that 5 cases of appendicitis in addition to the above general characteristics, but also has the following characteristics: are women, past physical health, acute disease, the onset of the primary disease-free; 5 cases of intraoperative findings are limited to mass After the outer wall of the cecum (no similar description of the literature),[link widoczny dla zalogowanych], 3 cases corresponding to the right side of lower back pain. We believe that all parts of 5 cases of disease after a fixed outer wall of the cecum this particular site, may be related to the mesangial area in the contralateral, relatively poor blood supply is related lower back pain right side in 3 cases and the disease is clearly the right retroperitoneal invasion related. Another 5 cases of this group, the predilection of this disease seems to suggest women, and non-white past with poor physical health may also be sick. 5 cases with no palpable mass before surgery, tumor location may be deeper, in patients with obesity or a medical examination not careful enough about. Because the clinical manifestations of this disease resembles acute appendicitis, both difficult to distinguish between the preoperative, operative findings and difficult nature of the tumor mass, such as Crohn's disease 27 - to identify, so the disease often see the appendix in acute appendicitis surgery Normal , probe found that edema of the cecum or mass before considering the disease, and even the majority of cases diagnosed in the autopsy. We, and the diagnosis and treatment in 5 cases with literature, that even have some knowledge of the disease often is difficult in the preoperative and intraoperative diagnosis, the key is similar to the clinical manifestations of the patients, especially associated with lower back pain and right tenderness are likely to think of this disease. B ultrasound and CT currently suggest that the local thickening of the cecum or the appendix and ileum or mass, to consider the local expansion of the disease, the two checks although no specific, but are thought to have high diagnostic value of [1 - 2]. Therefore, l clinical suspicion of this disease, should be the line B-, CT examination, will help to improve preoperative diagnosis. The disease are non-surgical and surgical treatment of two ways, as in most cases on the basis of the aforementioned primary disease incidence, so whether it is surgical or non surgical treatment the prognosis is poor,[link widoczny dla zalogowanych], so far of the disease by surgery or non-surgical treatment controversial [1 - 3], but they stressed the need to actively treat the primary disease. Main measures of non-surgical treatment: intestinal rest, decompression, nutritional support and use of broad-spectrum antibiotics for minor symptoms or disease early, but note that the disease can occur repeatedly, or worse, after a relapse may be cured. The principal means of surgical treatment: right hemicolectomy, end ileostomy, applicable to peritonitis, abdominal abscess, and perforation of evidence, n. 3J, most authors advocated right hemicolectomy is appropriate, but in favor of the poor general condition or severe peritonitis end ileostomy with more secure. 4 of 5 cases in this routine right hemicolectomy,[link widoczny dla zalogowanych], excision of necrotic tissue in 1 case underwent ileostomy El were cured, were followed up for a good prognosis, possibly related to the incidence of 5 cases of primary disease, and when no such situation is better on the whole body . Riseman J summed up in 6 cases such as the line appendix surgery cecal mass in case of accidents (2 cases of appendicitis), that the intraoperative difficulties in identifying the nature of the tumor,[link widoczny dla zalogowanych], this time line right hemicolectomy is a good way to solve the problem instantly. It should be noted is the rare reports of the disease, which may be related to low incidence of this disease,[link widoczny dla zalogowanych], but there may be no understanding of this disease, with the understanding of this disease will have more cases found. Etiology of this disease, disease-specific sites, pathogenesis, diagnosis and appropriate treatment to be studied further understanding.