Laboratory parameters of the 1st order – obligatory laboratory tests. Small blood count Differential blood count Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate). Urine status (rapid test for: pH, leukocytes, nitrite, protein, glucose, ketone, urobilinogen, bilirubin, blood), sediment. Laboratory parameters 2nd order – depending on the results of the history, physical … Appendicitis: Test and Diagnosis
Therapeutic Targets Avoidance of complications Healing of appendicitis Therapy recommendations Adults In uncomplicated acute appendicitis (i.e., no evidence of perforation of the appendix (“appendicitis rupture”) – see Medical Device Diagnostics for details – and/or peritonitis/peritonitis), antibiotic therapy (beta-lactams – amoxicillin + clavulanic acid or cefotaxime – possibly combined with imidazole) with observation and waiting is … Appendicitis: Drug Therapy
Obligatory medical device diagnostics. Abdominal ultrasonography (ultrasonography of abdominal organs). Indications of appendicitis: “Shooting target figure” (diameter > 6 mm) with anechoic mesh cap. Diameter (between longitudinal muscles and serosa) > 6 mm + echogenic environmental responseIn one study, children in whom the external diameter of the appendix was ≥ 7 mm had more than … Appendicitis: Diagnostic Tests
In the treatment of acute uncomplicated appendicitis, the first-line therapy in all age groups is appendectomy. In uncomplicated appendicitis, delaying appendectomy by 12 to 24 hours of ongoing antibiotic therapy from the time of diagnosis does not result in an increased rate of perforation. Patients with the clinical picture of complicated appendicitis should be operated … Appendicitis: Surgical Therapy
The following symptoms and complaints may indicate appendicitis (appendicitis): Pain, which usually occurs in the area of the right lower abdomen. Anorexia (loss of appetite) Nausea (nausea)/vomiting Urge to defecate Stool retention (in advanced stages a paralytic ileus/intestinal paralysis). Meteorism (flatulence) Slight to moderate temperature increase (38-39 °C; there is a temperature difference between rectal … Appendicitis: Symptoms, Complaints, Signs
Pathogenesis (development of disease) Appendicitis is caused in about half of cases by obstruction (Latin obstructio, closure) of the lumen diameter or the interior of a cavity of the appendiceal process. In other cases, the cause is ulceration (ulceration) of the mucosa of the appendix. Both lead to an increase in pressure inside the intestinal … Appendicitis: Causes
General measures Inpatient admission! Nicotine restriction (refraining from tobacco use). Alcohol restriction (abstaining from alcohol) Regular checkups Regular medical checkups Nutritional medicine Adherence to the following specific nutritional recommendations during illness: Sufficient fluid intake! Since during the course of a febrile illness there is a strong loss of fluids, fluid intake in adults with kidney … Appendicitis: Therapy
Medical history (history of illness) is an important component in the diagnosis of appendicitis (appendicitis). Family history What is the general health of your family members? Social history Is there any evidence of psychosocial stress or strain due to your family situation? Current medical history/systemic history (somatic and psychological complaints). Do you have abdominal pain? … Appendicitis: Medical History
Endocrine, nutritional, and metabolic diseases (E00-E90). Diabetes mellitus (diabetes). Food intolerances such as lactose intolerance, fructose intolerance. Porphyria or acute intermittent porphyria (AIP); genetic disease with autosomal dominant inheritance; patients with this disease have a 50 percent reduction in the activity of the enzyme porphobilinogen deaminase (PBG-D), which is sufficient for porphyrin synthesis. Triggers of … Appendicitis: Or something else? Differential Diagnosis
The following are the most important diseases or complications that can be caused by appendicitis (appendicitis): Mouth, esophagus (food pipe), stomach, and intestines (K00-K67; K90-93). Abdominal abscesses Appendiceal perforation* (“appendix rupture“). Peritonitis (inflammation of the peritoneum) Perityphlitic abscess – formation of an encapsulated collection of pus around the appendix. Recurrent appendicitis after appendectomy (appendectomy) (due … Appendicitis: Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body temperature, body weight, body height; furthermore: Inspection (viewing). Skin, mucous membranes, oral cavity and sclerae (white part of the eye) [secondary symptom: dry tongue]. Abdomen Shape of the abdomen? Skin color? Skin texture? Efflorescences … Appendicitis: Examination