外科25-急性阑尾炎英文医学培训课件.ppt

阑尾类癌 Treatment Operation- Appendectomy: 1. Acute appendicitis. 2. Ruptured appendix with local peritonitis or phlegmon(蜂窝织炎) formation. 3. Ruptured appendix with spreading peritonitis Antibiotics. Intervetional therapy: Abscess Supportive treatment: Bowel Fistula 特殊类型阑尾炎 Infant and children. Pregnancy The Elderly 急性单纯性阑尾炎（B超） 急性单纯性阑尾炎 急性化脓性阑尾炎（B超） 急性化脓性阑尾炎 坏疽穿孔性阑尾炎 坏疽性阑尾炎 亚急性阑尾炎 慢性阑尾炎 THREATMENT LAPAROSCOPIC SURGERY SIGNODSTOMY One of the most common conditions in children and adults. Patients usually present with periumbilical pain that later localizes to the right lower quadrant (RLQ) at McBurneys point. In most cases, pain is accompanied by mild anorexia and nausea or vomiting. In most situations, signs and symptoms can establish the diagnosis reliably. The combination of abdominal pain and tenderness accompanied by leukocytosis 12,000 cells/mm3 had the highest predictive value for acute appendicitis Appendicitis 4. In some patients there is a delay in diagnosis resulting in increased risk of perforation, sepsis, and even death. In a recent series of childhood appendicitis, all 10 patients10 yrs had a perforated appendix at the time of operation. In 35 children between 1-5 yrs with appendicitis perforation rate of 69%. 19.8% morbidity rate among pts with perforated appendicitis. The surgical literature: 25% of patients undergoing the negative appendectomy rate. The goal would be threefold: To diagnose appendicitis promptly in hope of reducing the rate of perforation and associated complications. To reduce the number of patients undergoing unnecessary removal of a normal appendix. After exclusion of appendicitis, to establish the etiology of the patients RLQ pain. Acute Appendicitis 急性阑尾炎 Outlines Incidence Anatomy Physiology Etiology Pathogenesis Essentials of Diagnosis Complications Differential Diagnosis Treatment Incidence The most common acute surgical condition of abdomen. (Occurs in 6% of the US population.) Most fr