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- March 10, 2011, 03:53:56 AMTreatment of appendicitis during pregnancy (report of 128 cases)
Shock, so the survival of the fetus before the fetus by cesarean section and then remove the appendix in 2 cases. The 4 cases of mother and child were safely discharged. 4. Results: The surgical wound infection cases, 14 cases, accounting for 11% (14/128). Pregnant women, 16 cases of toxic shock occurs, DIC2 cases, MOF2 patients, all out of danger after emergency treatment, but after abortion in 2 cases,You are not allowed to view links. Register or Login, 1 case of premature delivery, fetal death occurred before and after surgery in 1 case. There were no maternal deaths. Discussion 1. Diagnosis: early pregnancy signs and symptoms of appendicitis in pregnant patients with non-small differences in the incidence of appendicitis,You are not allowed to view links. Register or Login, but should be careful not to early pregnancy symptoms of appendicitis in pregnancy as a reaction to delayed treatment. Appendicitis late pregnancy changes the location of the appendix and the impact of progesterone, etc., to the diagnosis difficult. Must note the following points: ① often first manifested as right lower abdominal pain. The group of 66 patients with this symptom, accounting for 52%. ② mild symptoms of abdominal pain, muscle tension is not obvious, but systemic symptoms and blood WBC and body temperature higher. Appendicitis in late pregnancy, often in the uterus at the end point tenderness 2 to 3 refers to the lower right place, not in the uterus at the end of the top, right flank tenderness often, most of the colon inflated test negative, psoas muscle test positive rate of 90% or more. ③ Zhu Huanzhe left supine abdominal pain may have eased. ④ urine tests may be a small amount of red, white, 33 cases of this group, accounting for 26%. Do not misdiagnosed as urinary tract stones or infection, urinary stones usually manifested colic,You are not allowed to view links. Register or Login, B-group with strong light and urinary tract infection bladder irritation obvious. ⑤ appendicitis in pregnancy, surgery, gynecology doctor closely and strive to early diagnosis and timely treatment Surgical treatment of 533 *. 2. Treatment: ① timing of surgery: appendicitis during pregnancy, especially in advanced appendicitis in pregnancy has its own specialty, disease are complex, more complications to deal with difficulties. Currently more than advocates of early clinical surgery. But pregnancy is simple appendicitis chronic appendicitis and surgery and there are still differences. We advocate aggressive surgical treatment. The reason is that with the increase in the month of pregnancy, simple, chronic appendicitis, and increase the chance of recurrence is increasing. If this group 1 patient, 26 years old, pregnant 3 ~ 7t-month period, appendicitis 4 episodes, 4 light-patient treatment because the symptoms are refused surgery. To 8 months of pregnancy, peritonitis caused by perforated appendicitis, admission, and toxic shock after the stillbirth. We believe that more than 8 months of pregnancy perforated appendix, peritonitis should first child by cesarean section, and then remove the appendix, peritonitis due to perforation of fetal death after complications such as easily. ② position and Notch: early pregnancy and non pregnancy were consistent with appendicitis. Position in late pregnancy, appendicitis surgery to the right or left side lying hip raise the bit position can be both, right hip elevation position is simple, the best left lying exposed operative field. Incision or right to take the right rectus abdominal incision curved incision, usually for the right rectus incision often in order to facilitate intraoperative exploration. When the right lower quadrant tenderness was the right time can be curved abdominal incision, the advantage is simple. ③ Operation Precautions: pregnancy appendectomy during the whole operation must be carefully gentle. Uterine stretch, or stretch the use of curved retractor retractor,You are not allowed to view links. Register or Login, do not use right-angle retractor, so pull broken uterus. Cases of postoperative drainage must be located, to cigarettes for good drainage and stimulate small and will not be blocked uterine flattened, but frequently changes the dressing, keep incisions clean. Seek simple, effective surgery, without washing the whole abdominal cavity. Antibiotics, avoid using gentamicin, amikacin and other aminoglycoside antibiotics,You are not allowed to view links. Register or Login, in order to avoid adverse effects on the fetus. And obstetricians before and after surgery to close cooperation in the third trimester of fetal surgery should be timely caesarean section appendicitis fetus. [Author] GU Agriculture (1969 a), male, physician.
Shock, so the survival of the fetus before the fetus by cesarean section and then remove the appendix in 2 cases. The 4 cases of mother and child were safely discharged. 4. Results: The surgical wound infection cases, 14 cases, accounting for 11% (14/128). Pregnant women, 16 cases of toxic shock occurs, DIC2 cases, MOF2 patients, all out of danger after emergency treatment, but after abortion in 2 cases,You are not allowed to view links. Register or Login, 1 case of premature delivery, fetal death occurred before and after surgery in 1 case. There were no maternal deaths. Discussion 1. Diagnosis: early pregnancy signs and symptoms of appendicitis in pregnant patients with non-small differences in the incidence of appendicitis,You are not allowed to view links. Register or Login, but should be careful not to early pregnancy symptoms of appendicitis in pregnancy as a reaction to delayed treatment. Appendicitis late pregnancy changes the location of the appendix and the impact of progesterone, etc., to the diagnosis difficult. Must note the following points: ① often first manifested as right lower abdominal pain. The group of 66 patients with this symptom, accounting for 52%. ② mild symptoms of abdominal pain, muscle tension is not obvious, but systemic symptoms and blood WBC and body temperature higher. Appendicitis in late pregnancy, often in the uterus at the end point tenderness 2 to 3 refers to the lower right place, not in the uterus at the end of the top, right flank tenderness often, most of the colon inflated test negative, psoas muscle test positive rate of 90% or more. ③ Zhu Huanzhe left supine abdominal pain may have eased. ④ urine tests may be a small amount of red, white, 33 cases of this group, accounting for 26%. Do not misdiagnosed as urinary tract stones or infection, urinary stones usually manifested colic,You are not allowed to view links. Register or Login, B-group with strong light and urinary tract infection bladder irritation obvious. ⑤ appendicitis in pregnancy, surgery, gynecology doctor closely and strive to early diagnosis and timely treatment Surgical treatment of 533 *. 2. Treatment: ① timing of surgery: appendicitis during pregnancy, especially in advanced appendicitis in pregnancy has its own specialty, disease are complex, more complications to deal with difficulties. Currently more than advocates of early clinical surgery. But pregnancy is simple appendicitis chronic appendicitis and surgery and there are still differences. We advocate aggressive surgical treatment. The reason is that with the increase in the month of pregnancy, simple, chronic appendicitis, and increase the chance of recurrence is increasing. If this group 1 patient, 26 years old, pregnant 3 ~ 7t-month period, appendicitis 4 episodes, 4 light-patient treatment because the symptoms are refused surgery. To 8 months of pregnancy, peritonitis caused by perforated appendicitis, admission, and toxic shock after the stillbirth. We believe that more than 8 months of pregnancy perforated appendix, peritonitis should first child by cesarean section, and then remove the appendix, peritonitis due to perforation of fetal death after complications such as easily. ② position and Notch: early pregnancy and non pregnancy were consistent with appendicitis. Position in late pregnancy, appendicitis surgery to the right or left side lying hip raise the bit position can be both, right hip elevation position is simple, the best left lying exposed operative field. Incision or right to take the right rectus abdominal incision curved incision, usually for the right rectus incision often in order to facilitate intraoperative exploration. When the right lower quadrant tenderness was the right time can be curved abdominal incision, the advantage is simple. ③ Operation Precautions: pregnancy appendectomy during the whole operation must be carefully gentle. Uterine stretch, or stretch the use of curved retractor retractor,You are not allowed to view links. Register or Login, do not use right-angle retractor, so pull broken uterus. Cases of postoperative drainage must be located, to cigarettes for good drainage and stimulate small and will not be blocked uterine flattened, but frequently changes the dressing, keep incisions clean. Seek simple, effective surgery, without washing the whole abdominal cavity. Antibiotics, avoid using gentamicin, amikacin and other aminoglycoside antibiotics,You are not allowed to view links. Register or Login, in order to avoid adverse effects on the fetus. And obstetricians before and after surgery to close cooperation in the third trimester of fetal surgery should be timely caesarean section appendicitis fetus. [Author] GU Agriculture (1969 a), male, physician.