peritoneal

It is 10 clock. severe abdominal pain. You are in the ER. Day before you had a nice party with friends. Then came the pain of the navel (belly button). She thought first: aha, probably you ate something bad is going on. But it does not work. Once you have lost your appetite and vomited. The pain does not improve but worsen. After a day of suffering you decided to visit the hospital. Long taxi ride. Pain is shooting every time the car bumps into a pot. Nurses ask series of questions andPlace in a vacuum. It is a confused 90 years some women in the next room. She mumbles something unintelligible. The woman came from a nursing home. She suffers from Alzheimer's disease and cries every night over the past 7 years. It has several problems in the history of medicine. They took her to the emergency room after developing a fever. Nurse drawing blood. Pain becomes progressively worse. Change your position, pull your legs. The pain does not go away. If your ... Doctorsis? ER doctor finally sees. H + P and writes orders ER. A stretcher is rolled into a radiology department and take in a large machine such as a goal. Everyone leaves the machine and brings you big metal donut. They returned to the emergency room.

Surgical intern comes. He did not rest as clock 05:00. He is asking the same questions collar and pushes the stomach. A resident is tired. It pushes back the stomach. You have to wait, bored,complain about delays, call your relatives. E 'already clock 02:00. Eventually, the residence was to discuss the symptoms with visitors via the telephone. He tells you that you have appendicitis and CT scan confirmed. History and physicals are written. Admission orders are written. pre-operative orders are written. Antibiotics are prescribed. IV fluid is 80 ml per hour. You sign the consent for surgery. Transport children to take - depending on the severity of symptoms - or right on the floor.Participants will run first thing in the morning.

Classically appendicitis starts as a pain that started in the periumbilical region (around the belly button - you tip). The pain then moves to the right lower quadrant of the abdomen. Nausea and vomiting often present after the onset of pain. Classically, the patient has low grade fever (which means around 37-38 C or 101-102 F), a positive psoas sign (and lengthen the leg and this movement increases the pain), positive poke Rovsing (Doctorin the lower left quadrant of the abdomen, and fill in the right lower quadrant pain in you), leukocytosis. White blood cells are white blood cells - WBC. Usually there are about 4000-9000 white blood cells per microliter of blood for you. If you have inflammation in the body count increases.

Their pain during appendicitis classically localized at the point of Mc Burney. This is the third between the umbilicus and anterior superior iliac spine (this is the point of being stuck on the boneleading out of the pool - you can even crawl on the side of your abdomen). To confirm a physician can also groped to arouse Obturator sign - it will ask you to bend your knees and bring your heel to your groin - this maneuver increases the pain during appendicitis. Similar tests is to raise the leg as he lay on the stretcher. This movement also increases your pain.

Appendicitis is an inflammation of the plant, presumably due to narrowing of the lumen. Shrinkagehyperplasia of the system can be caused (ie too much growth, overgrowth of tissue). This option is usually in children. Another variant - is fecalith (small stools rocks), the effects of the plant in the lumen. This is usually in young adults.

Plant itself is a small part of the intestine. E 'pencil-sized sticks intestine. Good is a continuous tube. The mouth is the entrance. Ano is completed. Plant sticks out of the wall and ends blindly. It has only one entrance. The system isAppendix (part of - literally blind colon in Latin). System of ruminants (animals that chew grass as a cow) is very long and large. Investment in people, is reduced to pencil-size. But it does not disappear. There is a theory, that the system of role-playing games in immune defense. The walls of the reality system of lymphoid tissue filled with lymphocytes (white blood cells that are subtype). lymphatic system is responsible for immunity.

The removal ofThe Annex does not really change much immunity. However, there is something redundant. If it is inflamed, there is no reason to remove it.

Now is an acute appendicitis, acute inflammation of the appendix. Suffix "-itis" means inflammation in Latin. Appendicitis is the most common cause of acute abdomen. acute abdomen in surgery is a condition in the abdomen, which usually calls for urgent surgery.

It is necessary to diagnose appendicitis in the lower rightQuadrant pain.

The pain must be present with a history of the case (all the classic signs and loss of appetite) or leukocytosis (high white blood cell).

Patients often ask: Can I avoid surgery? You can treat me with antibiotics alone? He told me that it is possible to treat appendicitis with antibiotics alone. Please, do not want the surgery, my mother (father, brother, wife) told me to avoid surgery.

The answer is:You can try to avoid the probable, but the probability of death are much higher in the case of appendicitis without surgery. Untreated appendicitis can lead to a perforation in less than a day. Sun rises. Sun Goes Down. Conditioning bursts. So, is the first surgery of the primary solution. Occasionally, the surgeon also a system of normal appearance and no other problems explain the symptoms. E 'can remove the system anyway, because it is better to remove missing a normal looking, asmild case of appendicitis.

To be used for cooling of the infection before the operation, antibiotics doctors. Antibiotics can convert acute appendicitis in more chronic type. But the distance between the plant is the choice.

With modern technology it is much easier to distinguish between appendicitis and other causes of right lower abdominal pain. However, there is no evidence the diagnosis of 100%. Eventually, doctors treat with antibiotics alone, unless they are safe. Although modern CT scan showsAppendicitis to close almost 100%.

What would happen if you miss the burst appendix and appendicitis? Peritonitis - you are one of the most feared complication of surgery received. Once again "-itis" as inflammation. Peritoneum, ie the abdominal cavity.

It 'hard to describe the peritoneal cavity of the mold. This form is very complex. Simple explanation: the abdominal cavity as a closed bag. It is completely closed in both men

Women have smallHoles in the peritoneum. Oocytes (baby) go from the ovaries of the cavity of the abdomen first. The holes allow you to enter the peritoneum egg tubes. Fallopian tubes leading to the womb (uterus in English or Latin or greek Hyster in utero). Organs, the peritoneal cavity liners fall called by intra-peritoneal. There are extraperitoneal or retroperitoneal organs, partially covered or not apple-peritonealat all. It seems that the main function of the peritoneum (peritoneum) is to provide some lubrication for your courage. Although there are other features.

Now take a plastic bag, pour a little water or oil in it and seal. Placing a hand on one side of the bag, another hand - on the side of the bag and rub together. You can slip your hands. This is the idea of the peritoneum - intestine slips easily against each other, even if they are stretched of food and when they drive from digested food. When a bowel is perforated (perforated), the intestinal contents into the abdominal cavity of the walk. Colon (lower, bigger bowl), stool. Feces consist of bacteria on 3.2 (yes, there are so many of them). Now the small hole will result in a part of the intestines leakage of bacteria around the closed pocket of the peritoneum.

Guts have different mechanisms for protection against bacteria.> Peritoneal cavity do not 'have such protection.

small puncture in one part of the intestine caused you all on page courage are not protected on the outside (to the gut is out, but it is inside the abdominal cavity). This is the peritonitis (diffuse). What the surgeons are afraid. Look at you. E 'belly like half of you body. This is how half of you body is burning strong. Finally, it can lead to sepsis, a condition in which bacteriaBlood and infect other parts of the body. This is life-threatening complication.

Eventually, the local inflammation is closed and the formation of an abscess. Abscess is a collection of pus walled. Pus is a mixture of live and dead bacteria, dead white blood cells (leukocytes, WBC = white, leukocyte cell =), the infection that fought and died with honor, and dead tissue, the partially digested by bacteria and partly through the tissue leukocytes. Inflamed peritoneum (the lining of theabdominal cavity is called the peritoneum) and can easily get together and seal the infection - there will be local peritonitis. All liability may cause problems in the future - do not push a bit 'bolder food and sticks or chair. Intestinal blockage can occur in acute appendicitis as well. This is in part responsible for the nausea and vomiting. Sometimes, when antibiotics are used goes without surgery for appendicitis. It occurs in elderly patients.Patients may come to the hospital look like a hub, or a mass in the lower right abdomen, such as cancer.

with appendicitis diagnostic problem is that some other conditions that can mimic.

abdominal organs with the package. Other sources can cause abdominal pain lower right corner. Females can tuboovarian or ovarian abscess or ectopic pregnancy (ask for this reason, doctors urgently: When was your last period to take birth controlHormones? Were you bleeding?), Etc. Also, make sure to try the hormone chorionic related, if you are pregnant.

conscientious doctor asks you to do your consent, the rectal examination. Many people refuse to do so. I can understand that. Who wants someone sticks his finger in his ass. I would not do. But the rectal exam is a lot of information. Rectum - is the part of the intestine that is closest to the Back Orifice. Back Orifice is anus or anal canal named in Latin. The surgeons say thatthere are only two drawbacks to avoid rectal examination: a patient ano second surgeon has no fingers.

Rectal examination in appendicitis is usually insignificant. Maybe you can cause pain by scanning the side wall of the rectum, which is close to the plant. But the DRE can distinguish other diseases. During the rectal exam Hemorrhoids palpate the prostate to enlarge, uterus, prostate or nodules, can you feel the bottom of the peritonealCavities, etc., the blood on his finger told you to see internal bleeding. FOBT - - guaiac test or the name of the dye that turns blue in the presence of blood may finally rectal examination in dis-compression of the rectum to help the stool for small amount of blood can (called FOBT check out .. That's when hard stools bowel obstruction .

Normally, a rectal examination is more or less normal. But every surgeon has a story about how in time of war, once in five yearsfound something significant on rectal examination, something that every other doctor missed. Simply moving a finger in the ass. I saw a surgeon, a finger in a demented old women and drew a pessary. It 'was a membrane apple-size pink plastic, which should go into the vagina, but someone (at home?) Formulation (accidentally?) In the rectum of the woman. You really need to exert pressure in order to get large objects into the anus. The poor woman has suffered bowel obstruction for a week and wouldlikely to die if they stayed long enough.

Ok, back to appendicitis. Thus, doctors check white blood cell count can include infection or inflammation that result in unusually high. It is not specific for appendicitis, but confirms other results.

Next, the medical monitoring of urine - microscopic examination of urine. That detects red blood cells, white cells and bacteria in the urine. If there is inflammation or stones in the kidneys or bladder,Urinalysis is abnormal. A urine test is normal characteristic of appendicitis.

Next try to picture what's happening in your belly. An X-ray examination of the abdomen fecalith may be the cause of appendicitis (5%) to detect. free air through the perforations may be able to see the film plane.

A barium enema may be used. This is a test used in the X-ray contrast fluid from the anus to fill the gut. Sometimes the impression is to show the colon on the inflamed appendix. Barium EnemaYou can also exclude other mimicking appendicitis, intestinal problems.

The U.S. is a larger plant or an abscess. Ultrasound is painless, but the plant can be seen in only half of patients. Ultrasound is also useful in seamlessly with the ovaries, fallopian tubes and uterus. Ultrasound usually looks like a small thumb wheel on, put them in the room. Technical and hangs up on you guide the probe Gelly Belly.

Often, they go directly to the CT scan(Computed Tomography). Especially if the patient is pregnant. CT is relatively high body exposure to X-rays However, the timely diagnosis of appendicitis benefits outweigh the risks of radiation. CT-scan images are slicing your body.

What do they look? Like any inflammation causes swelling, the wall of the appendix is thickened. This is actually a defense mechanism - with swelling of the body attempts to wall, to seal in the area of infection andInflammation.

But it is useful to us because we can safely say that there is inflammation. The same applies to ultrasound.

CT scanning is expensive - about $ 1,000 in an American hospital, even if $ 40 in Russia.

If the TAC is taken at night, the CT image can be sent to Australia, Russia or India.

A radiologist is paid about U.S. $ 40 to read a single X-ray film. I think it does more for the reading of the TAC. It 's just $ 5 in India. Therefore,clinics as well as Harvard and Yale to adopt this model of work - sending CT scans, the cheap labor abroad. Especially at night. Half an hour after the fax from Australia. "Pericecal inflammatory mass in right iliac fossa consistent with a diagnosis of severe acute appendicitis." Any doctor can read an X-ray film or CT. Radiologists are doctors who specialize in reading the film. You can find one that lost by others.

At this point the diagnosisclearly in the rule. In these cases, if there is laparoscopy. Laparoscopy is a surgical procedure. fiber-optic tube with a tiny camera into the abdominal cavity through a small incision in the abdomen introduced.

However, there is no test for the diagnosis, appendicitis with 100% certainty.

The position of the material may vary. If it's longer than normal, may be annexed to go deep in the pelvis. It can move behind the colon (called a retro-caecal appendix). On one side is betterbecause retro-caecal system is less likely to rupture in the abdominal cavity, the other is difficult to diagnose and that it is difficult surgical approach. The inflammation in other organs, such as female pelvic organs may be similar to inflammation of the appendix. Pregnant women have moved into the abdomen attachment, the uterus. Athletic young adults can tolerate more pain and may not have obvious symptoms of appendicitis. Old patients are vague symptoms, such asgood.

Other inflammatory problems may mimic appendicitis. Surgeons often see patients with suspected appendicitis for a period of time to see if it solves the problem or suggest appendicitis more than another state. reproduce the conditions that appendicitis are:

1) Meckel's diverticulitis. 2) pelvic infection, an inflammatory disease of the tube and ovary. E 'to be treated with antibiotics alone, 3) liquid from the abdomen in the upper right corner in the lower abdomen and unloading due toinflammation similar to appendicitis. Then, for example, the patient has the disease of the gall bladder or liver abscess, but all signs indicate acute appendicitis. 4) diverticulitis occurring on the right. 5) The inflammation of the right kidney. 6), Crohn's disease or ulcerative colitis 7) Yersinia infection - bacteria, some form of food goes - as pasteurized milk. - Can cause appendicitis 8) of kidney stones 9) ectopic pregnancy, 10), ruptured ovarian cyst. And so on. There arecertain other requirements.

Appendectomy is usually carried out urgently. Thomeo is Latin for dissect or cut. Laparotomy - is the abdomen (belly), Latin in medicine. Laparotomy is opening the abdomen. Appendectomy is cutting appendix. Laparoscopy investigated (by volume) in the stomach. Antibiotics are usually given before surgery, when suspected appendicitis.

Few patients experienced mild appendicitis Limited "located in a small area. These patients may improve for several daysObservation if they were treated with antibiotics alone. Doctors can not be removed or the plant later. Chances are you were not one of these patients.

If a person can not see the doctor for several days, during appendicitis broken (yes, it happens sometimes, there are some tough guys), form an abscess, and perforation can be closed. It may first be treated with antibiotics, but that will require drainage later. Appendix A drain will be under ultrasound or CT-guided and removed after scanningAbscess resolves.

In modern surgeons offer laparoscopic appendectomy. Add laparoscope (it's like a small telescope with a camera) and remove the appendix with special instruments through small punctures.

If you have had this type of surgery, you probably have four grains of 1 cm, and come home in a day or two.

But if your case is complicated or there are simply no laparoscopy at the clinic, they will do classic appendectomy. Surgeon size of 10 cmIncision near the plant. Plant away form the lower right abdomen or where it is. The area is checked for other problems. In the case of purulent abscess stuff will be removed with rubber tubes through the skin. With this type of surgery is likely four to seven days ago. Antibiotics help to resolve the abscess.

Therefore, you must sign the agreement: "laparoscopic appendectomy, the possible conversion to an open appendectomy.

The most commonComplication of appendectomy is infection of the wound. If it is heavy, closing the surgical incision is to move for a few days.

I have now, these four small scars or scar large, you go home and visit the part that you missed.

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