fifth day syndrome
Introduction
Introduction to the fifth day syndrome The fifth day syndrome (FifthDaySyndrome) is also known as the fifth day syndrome after appendectomy in children. The operation procedure of appendicitis in children is smooth. After 4 to 5 days (a few days until the 8th day), abdominal pain suddenly occurs, high fever, after a few hours. Developed as a sign of diffuse peritonitis. The cause is still unclear. Some people think that it may be caused by immunodeficiency and the defense function is weakened. basic knowledge Sickness ratio: 0.05% Susceptible people: no specific population Mode of infection: non-infectious Complications: acute appendicitis, chronic appendicitis
Cause
The fifth day of the cause of the syndrome
The cause is still unclear. Some people think that it may be caused by immunodeficiency and the defense function is weakened. PelLerin et al. performed re-laparotomy on 35 cases and found that the abdominal wall edema reaction did not occur, and there was no suffocation in the ileocecal area. The appendix stump was intact.
Some people have embedding the appendix stump as a cause or a postoperative complication. It is also believed that the use of thick sutures in the cecum is a possible cause. Further, the extension is considered to be the result of the weakening of the immunodeficiency and anti-epidemic function.
Prevention
Fifth day syndrome prevention
Since the disease occurs after the appendectomy in children, prevention of appendicitis is the basic measure to prevent this disease.
Complication
Fifth day syndrome complications Complications Acute appendicitis chronic appendicitis
Acute appendicitis, chronic appendicitis, etc.
Symptom
Symptoms of the fifth day syndrome Common symptoms Abdominal pain Lower abdomen rebound leukocytosis High fever Abdominal partial or wide...
1. Short course of disease, no true peritonitis sign.
2. The operation was smooth, no abnormalities were found during the operation and surgery, and the incision was not infected.
3. On the 5th day after surgery, abdominal pain, hyperthermia and peritonitis appeared suddenly.
4. Conservative treatment can quickly relieve the symptoms and no abnormal findings in the laparotomy.
Examine
Fifth day syndrome check
CT, blood routine, X-ray examination.
Diagnosis
Fifth day syndrome diagnosis
diagnosis
Can be diagnosed based on clinical performance and laboratory tests.
Differential diagnosis
According to the history and the occurrence of peritoneal irritation, the diagnosis of secondary peritonitis is mostly difficult, but in some patients, it is difficult to determine the cause and judge whether the operation is immediate, which requires close observation of the evolution of the disease and necessary examination.
X-ray plain film in the abdominal vertical position can observe the presence or absence of free gas under the armpit caused by gastrointestinal perforation, and the X-ray manifestations of strangulated intestinal obstruction, such as small-span tortuous intestines arranged in various forms during intestinal torsion, jejunum and ileum transposition, in the abdominal stenosis, can be isolated, prominent inflated intestinal fistula, do not change position due to time, or have pseudo-tumor shadow, epidural fat line blurred or disappeared directly suggesting peritoneal inflammation .
Diagnostic abdominal puncture has a very important role, such as pumping a purulent liquid, and even a lot of white blood cells or pus cells can be diagnosed by high-powered microscopy. If necessary, fine needles can be used in different parts of the abdominal cavity without anesthesia. Puncture, the pumped liquid can reflect the situation in the abdominal cavity.
If the abdominal pain is mainly in the middle and lower abdomen, a digital rectal examination should be performed. If the blood-stained substance refers to intussusception, intestinal torsion, inflammatory bowel disease or neoplastic lesion, the rectal uterus or rectal bladder lacuna has tenderness. Fullness, suggesting inflammation or empyema, married women can still puncture through the vagina.
If necessary, B-mode ultrasound and computed tomography scans can be used to understand whether there is an inflammatory change in the corresponding organs in the abdomen.
