小结
定义
A apendicite aguda é uma inflamação aguda do apêndice vermiforme, muito provavelmente decorrente de obstrução do lúmen do apêndice (por fecálito, fezes normais, agentes infecciosos ou hiperplasia linfoide).[1][2][Figure caption and citation for the preceding image starts]: Apendicite aguda - espécime intraoperatórioNasim Ahmed, MBBS, FACS; usado com permissão [Citation ends].
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
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
危险因素
- diferenças no microbioma apendicular
- tabagismo
诊断性检查
首要检查
- Hemograma completo
- proteína C-reativa
- tomografia computadorizada (TC) abdominal e pélvica
需考虑的检查
- ultrassonografia abdominal
- urinálise
- teste de urina para detecção de gravidez
- RNM abdominal e pélvica na gestação
新兴检查
- proporção neutrófilos/linfócitos
- sódio sérico
- pentraxina-3
- amiloide A sérica
- índices plaquetários
治疗流程
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
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
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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