阑尾炎(英文)PPT课件.ppt

surgery
Acute Appendicitis
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Anatomy
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Varied anatomy
Length: 5~10 cm, narrow lumen
haustra of colon
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Epidemiology
The most common acute abdomen disease
The incidence of appendectomy appears to be declining due to more accurate preoperative diagnosis.
Despite newer imaging techniques, acute appendicitis can be very difficult to diagnose.
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Pathophisiology
Simple appendicitis
Suppurative appendicitis
Gangrenous appendicitis
Perforated appendicitis
Peritonitis
Abscess around the appendix
Mucocele of appendix
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Pathophysiology
Acute appendicitis is thought to begin with obstruction of the lumen
Obstruction can result from food matter, adhesions, or lymphoid hyperplasia
Appendix is twisted, and Lumen of appendix is narrow, result in obstruction
Mucosal secretions continue to increase intraluminal pressure
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Etiology
1. The anatomy characteristics
2. The tissue features
3. fecality, foreign body obstruction
4. Parasites cause the mucosa damage
5. adhesion, pressure cause appendix distorted
Obstruction → high pressure→ limph obstructed, ischemia →mucosa damage→ bacteria invade（70%～80%）
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Artery
The appendix artery has no branches, is easily to be obstacled
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Etiology
Eventually the pressure exceeds capillary perfusion pressure and venous and lymphatic drainage are obstructed.
With vascular compromise, epithelial mucosa breaks down and bacterial invasion by bowel flora occurs.
microbes：Ecoli, streptococcus, Pseudomonas, anaerobe
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