Appendicitis

Under a appendicitis is an acute inflammation of the appendix, which typically leads to abdominal pain, loss of appetite and pain-sensitive strained abdominal wall.

Under a appendicitis is an acute inflammation of the appendix, which typically leads to abdominal pain, loss of appetite and pain-sensitive strained abdominal wall. The diagnosis is made clinically, often supported by CT or ultrasound. Treatment includes appendectomy. In the US, acute appendicitis is the most common cause of surgery in acute abdomen. More than 5% of the population develop at some point in their lives appendicitis. It is most common in teens and in the third decade of life, but can in principle occur at any age. Other findings that may occur under the picture of appendicitis are carcinoid tumors, cancer, villous adenomas, and diverticula. The appendix can also be affected in Crohn’s disease and ulcerative colitis in a Pancolitis (inflammatory bowel disease). Etiology It is believed that the appendicitis caused by a relocation of Appendixlumens, typically caused by a lymphoid hyperplasia, rarely by faecal stones, debris, or even worms. The closure leads to swelling, bacterial overgrowth, ischemia and inflammation. Untreated occur necrosis, gangrene and perforation. If the perforation is enveloped by the surrounding network, an abscess can develop. Symptoms and signs The classic symptoms of acute appendicitis are an epigastric pain and Periumbilical with subsequent short duration nausea, vomiting and anorexia. After a few hours of pain in the right lower quadrant shifts. The pain is aggravated by coughing and movement. Classic signs of appendicitis are Direct and rebound tenderness in the right lower quadrant, at the so-called. McBurney’s point (transition from the middle to outer third of the line that connects the umbilicus to the anterior superior iliac spine). Other signs of appendicitis pain that is felt in palpation in the lower right quadrant (Rovsing mark), an increase in passive stretching in the right hip, whereby the Iliopsoasmuskel is stretched (psoas sign), or pain caused by passive internal rotation caused the diffracted thigh (obturator characters). There is often a slight fever (rectal temperature 37.7 to 38.3 ° C). Unfortunately, these classical findings set only at <50% of patients. For symptoms and signs of appendicitis many variations occur. It is possible that the pain can not locate, especially in infants and children. The pain can be diffuse or, in rare cases, entirely absent. Bowel movements are less frequent or absent in general; If diarrhea occurs, a retrozökale Appendix should be suspected. Erythrocytes or leukocytes are excreted in the urine. Atypical symptoms are common in elderly patients and pregnant women; in particular, the pain is less and the local pain sensitivity is less pronounced. Diagnosis Clinical evaluation abdominal CT if necessary ultrasound to CT If a classic for appendicitis symptomatology is alternatively possible to make the diagnosis of appendicitis clinically. If one delays the surgical treatment of appendicitis in these patients in order to use imaging techniques, it only increases the probability of a perforation and subsequent complications. In patients with atypical or dubious findings imaging method should be used without delay. The contrast-enhanced CT is sufficiently accurate in the diagnosis of appendicitis and can reveal other causes of acute abdomen simultaneously. An ultrasound examination can be carried out usually fast and does not radiation exposure (especially important in children); However, it is less meaningful and less useful in the diagnosis of other causes of pain due to intestinal gas overlays often. Appendicitis is a clinical diagnosis in the first place. The selective and judicious use of radiological studies can reduce the rate of negative laparotomy. Laparoscopy can be used for diagnosis as well as the definitive treatment of appendicitis. It can be useful with unclear lower abdominal pain especially in women. A normal white blood cell count should not lead to exclude appendicitis. Laboratory test results typically show a leukocytosis (12,000-15,000 / ul), but this finding is very variable. Acute appendicitis figure provided by Parswa Ansari, M.D. var model = {thumbnailUrl: '/-/media/manual/professional/images/acute_appendicitis_high_de.jpg?la=de&thn=0&mw=350' imageUrl: '/-/media/manual/professional/images/acute_appendicitis_high_de.jpg?la = en & thn = 0 ', title:' Acute appendicitis 'description:' u003Ca id = "v38395135 " class = ""anchor "" u003e u003c / a u003e u003cdiv class = ""para "" u003e u003cp u003eDieses image shows an enlarged

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