阑尾炎(英文).ppt

surgery
Acute Appendicitis
Anatomy
Varied anatomy
Length: 5~10 cm, narrow lumen
haustra of colon
Epidemiology
The mon 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.
Pathophisiology
Simple appendicitis
Suppurative appendicitis
Gangrenous appendicitis
Perforated appendicitis
Peritonitis
Abscess around the appendix
Mucocele of appendix
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
Artery
The appendix artery has no branches, is easily to be obstacled
Etiology
Eventually the pressure exceeds capillary perfusion pressure and venous and lymphatic drainage are obstructed.
With promise, epithelial mucosa breaks down and bacterial invasion by bowel flora occurs.
microbes:Ecoli, us, Pseudomonas, anaerobe