appendix infection
Introduction
Introduction Iris, Vermiform Appendix, is a degenerate organ of humans (the herbivore's appendix is very developed), about 7-9 cm long and about 0.5 cm in diameter. It is located in the lower right part of the abdomen, inside the cecum, and the proximal end is connected to the cecum. End blocking. Because the appendix cavity is small, it is a blind tube. Food debris and fecal stones can easily fall into the cavity and block the lumen causing inflammation. The body surface projection is called MacBurney point, which is located outside the right anterior superior iliac spine to the umbilical cord. At the middle 1/3 junction, there is tenderness at the point of appendicitis. The appendix in adults is mainly related to immune function. Soon after birth, lymphoid tissue begins to accumulate in the appendix, peaks at around 20 years old, then rapidly declines, and disappears after 60 years of age. However, at the stage of physical development, the appendix can function as a lymphoid organ, promoting the maturation of B lymphocytes (a type of white blood cells) and the production of immunoglobulin class A antibodies. The researchers also showed that the molecules involved in the production of the appendix help lymphocytes transfer to other parts of the body. Most infections of the appendix appear after surgery.
Cause
Cause
The main cause of infection:
(1) Fat liquefaction. Especially when there is more fat in the incision and electrosurgical operation, the mechanism may be due to the superficial burn of subcutaneous fat tissue caused by the high temperature generated by the electrocautery and the degeneration of some fat cells due to thermal damage, and the capillary in the adipose tissue. Due to coagulation, the blood supply of the hypertrophic adipose tissue with poor blood supply is further impaired, and the adipose tissue is aseptically necrotic, resulting in more exudate, which affects the healing of the incision.
(2) Aseptic toxicity. The incision has a long exposure time, and it is easy to undergo oxidative decomposition reaction under the action of mechanical action such as extrusion, clamping, etc., causing aseptic toxicity reaction and liquefaction of adipose tissue. The size of the virulence of the bacteria, whether there is a hematoma opening foreign body in the wound, the strength of the local tissue and the body resistance, whether the sterilization operation is strictly the main influencing factor of the wound infection, in addition, improper treatment of the incision fat liquefaction can also cause infection.
(3) Systemic factors. The general state of the body mainly includes old and weak, malignant diseases, diabetes, low plasma protein, anemia, liver and kidney dysfunction, perioperative use of glucocorticoids, etc., can affect the healing of the incision.
Examine
an examination
Related inspection
Closed-hole internal muscle test Ultrasound examination of gastrointestinal diseases CT examination of gastrointestinal tract
Appendice infections generally have clinical manifestations of abdominal pain.
The total number of white blood cells and the number of neutrophils can be mildly or moderately increased. The total number of white blood cells is more than 10×109/L, and the neutrophils are often above 80%. If peritonitis occurs in perforation, it can often rise to 20×109/ Above L, stool and urine routines are basically normal.
Chest fluoroscopy can eliminate the misdiagnosis of appendicitis in the right chest disease, and the presence of other surgical acute abdomen such as free gas under the armpit. Abdominal X-ray examination: The cecum and external colon are inflated. When the local inflammation is obvious, the edge of the right psoas muscle is unclear, and the edge of the right lower abdomen abdominal fat line is blurred and widened or disappeared. If it is a pelvic appendix, it can be seen that the pelvic fat line disappears.
Diagnosis
Differential diagnosis
The traditional misconceptions about the appendix should be completely corrected:
1. Appendicitis is appendicitis. Because the appendix is close to the cecum, many people confuse appendicitis with appendicitis. In fact, they are two different diseases;
2. It is considered that the appendix is a degenerating organ in the process of human evolution, and has no important physiological functions. The removal of the appendix has no adverse effect on the body. Modern medical research has many new understandings of the appendix function, especially the development of immunology and transplant surgery. It reminds clinical surgeons that the indications for appendectomy should be strictly controlled, and the attached appendectomy should be more cautious. The appendix is rich in lymphoid tissues and participates in the immune function of the body. It should be attributed to the central immune organs. It is responsible for the cellular immunity and humoral immunity of the body. The latest research results confirm that the appendix also has secretory cells, which can secrete a variety of substances and various digestive enzymes, as well as hormones and growth-related hormones that promote intestinal peristalsis.
Appendice infections generally have clinical manifestations of abdominal pain.
