Резюме
Определение
Acute appendicitis is an acute inflammation of the vermiform appendix, most likely due to obstruction of the lumen of the appendix (by fecalith, normal stool, infective agents, or lymphoid hyperplasia).[1][2][Figure caption and citation for the preceding image starts]: Acute appendicitis - intraoperative specimen.Nasim Ahmed, MBBS, FACS; used with permission [Citation ends].
Анамнез и осмотр
Ключевые диагностические факторы
- abdominal pain
- anorexia
- nausea and vomiting
- right lower quadrant tenderness
- tense rigid abdomen
- hypotension and tachycardia
- palpable mass
Другие диагностические факторы
- age of occurrence
- fever
- flushed face and a fetor
- diminished bowel sounds
- tachycardia
- loose stool
- constipation
- Rovsing sign
- psoas sign
- obturator sign
Факторы риска
- differences in the appendiceal microbiome
- smoking
Диагностические исследования
Исследования, которые показаны в первую очередь
- CBC
- CRP
- abdominal and pelvic CT scan
Исследования, проведение которых нужно рассмотреть
- abdominal ultrasound
- urinalysis
- urinary pregnancy test
- abdominal and pelvic MRI in pregnancy
Неотложные исследования
- Neutrophil-to-lymphocyte ratio
- serum sodium
- pentraxin-3
- serum amyloid A
- platelet indices
Алгоритм лечения
uncomplicated acute appendicitis
ill with perforation or abscess
Составители
Эксперты-консультанты
Peter Szasz, MD, PhD, FRCSC
Assistant Professor
Department of Surgery
Queen's University
Kingston
Ontario
Canada
Раскрытие информации
PS declares that he has no competing interests.
Elisabeth Adderson, MD
Associate Member
St. Jude Children's Research Hospital
Associate Professor of Pediatrics
University of Tennessee Health Sciences Center
Memphis
TN
Раскрытие информации
EA declares that she has no competing interests.
Рецензенты
John M. Davis, MD
General Surgery
Jersey Shore Medical Center
Neptune
NJ
Раскрытие информации
JMD declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Список литературы
Основные статьи
Di Saverio S, Podda M, De Simone B, et al. Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines. World J Emerg Surg. 2020 Apr 15;15(1):27.Полный текст Аннотация
American College of Radiology. ACR appropriateness criteria: right lower quadrant pain - suspected appendicitis. 2022 [internet publication].Полный текст
Sartelli M, Chichom-Mefire A, Labricciosa FM, et al. The management of intra-abdominal infections from a global perspective: 2017 WSES guidelines for management of intra-abdominal infections. World J Emerg Surg. 2017 Jul 10;12:29.Полный текст Аннотация
Статьи, указанные как источники
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Отличия
- Acute mesenteric adenitis
- Viral gastroenteritis
- Meckel diverticulitis
Больше ОтличияРекомендации
- SAGES guideline for the diagnosis and treatment of appendicitis
- Acute abdominal pain
Больше РекомендацииКалькуляторы
APACHE II scoring system
Больше КалькуляторыVideos
Venepuncture and phlebotomy: animated demonstration
Peripheral intravascular catheter: animated demonstration
Больше ВидеоЛифлеты для пациента
Appendicitis
Больше Лифлеты для пациента
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