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Apendicite aguda

最后审阅: 25 Sep 2025
最后更新: 17 Apr 2025

小结

定义

病史和体格检查

关键诊断因素

  • dor abdominal
  • anorexia
  • náuseas e vômitos
  • sensibilidade no quadrante inferior direito
  • abdome tenso e rígido
  • hipotensão e taquicardia
  • massa palpável
完整详情

其他诊断因素

  • idade de ocorrência
  • febre
  • rosto corado e halitose
  • diminuição dos ruídos hidroaéreos
  • taquicardia
  • evacuação diarreica
  • constipação
  • sinal de Rovsing
  • sinal do psoas
  • sinal do obturador
完整详情

危险因素

  • diferenças no microbioma apendicular
  • tabagismo
完整详情

诊断性检查

首要检查

  • Hemograma completo
  • proteína C-reativa
  • tomografia computadorizada (TC) abdominal e pélvica
完整详情

需考虑的检查

  • ultrassonografia abdominal
  • urinálise
  • teste de urina para detecção de gravidez
  • RNM abdominal e pélvica na gestação
完整详情

新兴检查

  • proporção neutrófilos/linfócitos
  • sódio sérico
  • pentraxina-3
  • amiloide A sérica
  • índices plaquetários

治疗流程

急症处理

apendicite aguda não complicada

debilitado, com perfuração ou abscesso

撰稿人

作者

Peter Szasz, MD, PhD, FRCSC

Assistant Professor

Department of Surgery

Queen's University

Kingston

Ontario

Canada

利益声明

PS declares that he has no competing interests.

鸣谢

Dr Peter Szasz would like to gratefully acknowledge Professor Ali Tavakkoli, Professor Dileep N. Lobo and Dr Nasim Ahmed, previous contributors to this topic.

利益声明

AT is a consultant for Medtronic. DNL is the author of an article cited in the topic. NA declares that he has no competing interests.

同行评议者

John M. Davis, MD

General Surgery

Jersey Shore Medical Center

Neptune

NJ

利益声明

JMD declares that he has no competing interests.

Elisabeth Adderson, MD

Associate Member

St. Jude Children's Research Hospital

Associate Professor of Paediatrics

University of Tennessee Health Sciences Center

Memphis

TN

利益声明

EA declares that she 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.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

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.全文  摘要

American College of Radiology. ACR appropriateness criteria: right lower quadrant pain - suspected appendicitis. 2022 [internet publication].全文

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.全文  摘要

参考文献

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