阑尾炎(英文)PPT演示课件
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《阑尾炎英文》课件
3
Screening Tests
Currently, there are no specific screening tests available for appendicitis.
Conclusion
1 Summary of Key Points
Appendicitis is a common condition characterized by inflammation of the appendix. Diagnosis is based on physical examination and imaging tests, and treatment usually involves surgery. Complications can occur if left untreated. Prevention includes diet and lifestyle changes.
Abscess Formation
An abscess may form around the appendix, requiring drainage and additional treatment.
Postoperative Complications
Possible complications following appendectomy include wound infection, bleeding, and intestinal blockage.
Differential Diagnosis
It is important to differentiate appendicitis from other conditions such as gastroenteritis, kidney stones, and ovarian cysts.
阑尾炎课件Acute_appendicitis
内、外瘘:阑尾周围脓肿如未及时引流，一部分病 例脓肿可向小肠或大肠内穿破，也可向膀胱、阴道 或腹壁穿破，形成各种内瘘或外瘘。X线钡餐了解 瘘管的走行和范围，选择扩大引流或切除瘘管。
门静脉炎(pylephlebitis):阑尾静脉中的感染性血栓， 沿肠系膜上静脉至门静脉，致门静脉炎症。临床有 肝肿大和压痛、黄疸、畏寒、高热等。可发展为细 菌性肝脓肿。
a:盲肠右位 b:盲肠前位 c:回肠右位 d: 回肠前位 e:回肠下位 f:盲肠内位 g:盲肠下位 h:盲肠外位
盲肠后位 盲肠外侧位
盲肠下位
回肠前位 回肠后位
盆位
解剖与生理
动脉来自回结肠动脉，终末血管，无交通支。 静脉与动脉伴行，最后汇入门静脉，阑尾炎 可引起门静脉炎或肝脓肿。 阑尾神经传入脊髓节段在10、11，故阑尾炎 初期表现为上腹或脐周牵涉痛。 阑尾有丰富的淋巴组织，参与免疫功能。 显微外科:利用自体阑尾移植替代某些管道如 输尿管、尿道的缺损和狭窄。
急性单纯性阑尾炎
急性单纯性阑尾炎
急性穿孔性(坏疽性)阑尾炎
急性穿孔性(坏疽性)阑尾炎
急性穿孔性(坏疽性)阑尾炎
急性穿孔性(坏疽性)阑尾炎
正常 阑尾
急性阑尾炎
吸收
慢性阑尾炎
阑尾周围脓肿
急性单纯性阑尾炎
化脓性阑尾炎
坏疽性阑尾炎
弥蔓性
死
腹膜炎
亡
【临床表现】
腹痛:
➢ 开始于脐周和上腹部，开始痛不严重，位置不固定， 呈阵发性，系阑尾管腔阻塞后扩张、收缩引起的内 脏神经反射性疼痛。
手术治疗
适应症:各类急性阑尾炎，慢性阑尾炎，阑尾脓肿保 守3个月后仍有症状者及非手术治疗无效者。
术前准备:禁饮食4-6小时，确定手术时间后可给适量 的镇痛剂，已化脓和穿孔者应给以广谱抗菌素。有 弥蔓性腹膜炎者，需行胃肠减压，静脉输液。
门静脉炎(pylephlebitis):阑尾静脉中的感染性血栓， 沿肠系膜上静脉至门静脉，致门静脉炎症。临床有 肝肿大和压痛、黄疸、畏寒、高热等。可发展为细 菌性肝脓肿。
a:盲肠右位 b:盲肠前位 c:回肠右位 d: 回肠前位 e:回肠下位 f:盲肠内位 g:盲肠下位 h:盲肠外位
盲肠后位 盲肠外侧位
盲肠下位
回肠前位 回肠后位
盆位
解剖与生理
动脉来自回结肠动脉，终末血管，无交通支。 静脉与动脉伴行，最后汇入门静脉，阑尾炎 可引起门静脉炎或肝脓肿。 阑尾神经传入脊髓节段在10、11，故阑尾炎 初期表现为上腹或脐周牵涉痛。 阑尾有丰富的淋巴组织，参与免疫功能。 显微外科:利用自体阑尾移植替代某些管道如 输尿管、尿道的缺损和狭窄。
急性单纯性阑尾炎
急性单纯性阑尾炎
急性穿孔性(坏疽性)阑尾炎
急性穿孔性(坏疽性)阑尾炎
急性穿孔性(坏疽性)阑尾炎
急性穿孔性(坏疽性)阑尾炎
正常 阑尾
急性阑尾炎
吸收
慢性阑尾炎
阑尾周围脓肿
急性单纯性阑尾炎
化脓性阑尾炎
坏疽性阑尾炎
弥蔓性
死
腹膜炎
亡
【临床表现】
腹痛:
➢ 开始于脐周和上腹部，开始痛不严重，位置不固定， 呈阵发性，系阑尾管腔阻塞后扩张、收缩引起的内 脏神经反射性疼痛。
手术治疗
适应症:各类急性阑尾炎，慢性阑尾炎，阑尾脓肿保 守3个月后仍有症状者及非手术治疗无效者。
术前准备:禁饮食4-6小时，确定手术时间后可给适量 的镇痛剂，已化脓和穿孔者应给以广谱抗菌素。有 弥蔓性腹膜炎者，需行胃肠减压，静脉输液。
阑尾炎(英文)PPT课件
2019/12/14
10
Etiology
Increased pressure also leads to arterial stasis and tissue infarction
End result is perforation and spillage of infected appendiceal contents into the peritoneum
distorted
Obstruction → high pressure→ limph obstructed, ischemia →mucosa damage→ bacteria invade（70%～80%）
2019/12/14
8
Artery
The appendix artery has no
2019/12/14
5
Pathophisiology
Simple appendicitis Suppurative appendicitis Gangrenous appendicitis Perforated appendicitis Peritonitis Abscess around the appendix Mucocele of appendix
With vascular compromise, epithelial mucosa breaks down and bacterial invasion by bowel flora occurs.
microbes：Ecoli, streptococcus, Pseudomonas, anaerobe
Pain is typically felt in the periumbilical or epigastric area.
阑尾炎(英文)PPT演示幻灯片
Βιβλιοθήκη 7Etiology
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
As inflammation continues, the serosa and adjacent structures become inflamed
This triggers somatic pain fibers, innervating the peritoneal structures
Appendix is twisted, and Lumen of appendix is narrow, result in obstruction
Mucosal secretions continue to increase intraluminal pressure
Central-South University
Typically causing pain in the RLQ
Central-South University
13
Pathophysiology
The change in stimulation form visceral to somatic pain fibers explains the classic migration of pain in the periumbilical area to the RLQ seen with acute appendicitis.
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
As inflammation continues, the serosa and adjacent structures become inflamed
This triggers somatic pain fibers, innervating the peritoneal structures
Appendix is twisted, and Lumen of appendix is narrow, result in obstruction
Mucosal secretions continue to increase intraluminal pressure
Central-South University
Typically causing pain in the RLQ
Central-South University
13
Pathophysiology
The change in stimulation form visceral to somatic pain fibers explains the classic migration of pain in the periumbilical area to the RLQ seen with acute appendicitis.
阑尾炎(英文) PPT
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
Pain is typically felt in the periumbilical or epigastric area.
As inflammation continues, the serosa and adjacent structures become inflamed
This triggers somatic pain fibers, innervating the peritoneal structures
Pelvic appendix may irritate the bladder or rectum causing suprapubic pain, pain with urination, or feeling the need to defecate
阑尾炎(英文)
Varied anatomy
haustra of colon
Length: 5~10 cm, narrow lumen
The most common acute abdomen disease
The incidence of appendectomy appears to be declining due to more accurate preoperative diagnosis.
阑尾炎幻灯.ppt
异位阑尾炎腹痛部位根据阑尾位置而定 盲肠后位阑尾炎局部疼痛可不剧烈，甚至腰 痛重于腹痛；
盆位阑尾炎腹痛位置较低，可在耻骨上区； 肝下区阑尾炎可引起右上腹痛，
极少数左下腹部阑尾炎呈左下腹痛。这些均 可给诊断带来困难。
胃肠道症状： 恶心、呕吐也是阑尾炎的常见症状，
其他消化道症状如厌食，便秘、腹泻等也偶 有出现。盆腔位阑尾炎，炎症刺激直肠和膀 胱，引起排便、里急后重症状。
2. 急性肠系膜淋巴结炎
3. 其他回盲部疾病，如肿瘤、局限性回肠 炎、美克耳(Meckel)憩室炎或穿孔等，均 可引起右下腹痛，亦需进行临床鉴别。
治疗
目前公认急性阑尾炎的治疗方法为手术切 除阑尾，但具体应根据患者的全身情况和 局部病理变化选择治疗方法。
非手术治疗
其适应症包括： （1）轻症急性单纯性阑尾炎； （2）客观条件不允许或患者拒绝手术；
（6）盲肠壁内阑尾，阑尾位于盲肠浆膜下，须切开浆 膜才能发现阑尾。
2. 功能
近年来证明阑尾是一个淋巴器官，参与B淋 巴细胞的产生和成熟。 阑尾的淋巴组织在出生后就开始出现，12— 20岁时达高峰期，以后逐渐减少，30岁后滤 泡明显减少，60岁后完全消失。
３急性阑尾炎(acute appendicitis)
（3）合并严重的器质性疾病有手术禁忌 症者； （4）阑尾周围脓肿。
非手术治疗包括
卧床休息、流质饮食或禁食、 应用抗生素治疗， 并发阑尾周围脓肿者还可加用中药治疗。
治疗期间应密切观察病情变化，如病情不 见好转甚至加重者，应及时进行手术治疗。
手术治疗
不同类型急性阑尾炎的手术方法： 1)急性单纯性阑尾炎：行阑尾切除术，
阑尾炎症重，发展快，未及时治疗，又没被 大网膜包裹局限，炎症扩散，发展为弥漫性 腹膜炎。
阑尾炎(英文)PPT课件
As inflammation continues, the serosa and adjacent structures become inflamed
This triggers somatic pain fibers, innervating the peritoneal structures
.
7
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
This pain is generally vague and poorly localized.
Pain is typically felt in the periumbilical or epigastric area.
Central-South University
.
12
Pathophysiology
Central-South University
.
9
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.
This triggers somatic pain fibers, innervating the peritoneal structures
.
7
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
This pain is generally vague and poorly localized.
Pain is typically felt in the periumbilical or epigastric area.
Central-South University
.
12
Pathophysiology
Central-South University
.
9
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.
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In pregnancy, the appendix can be shifted and patients can present with RUQ pain
15
Pathophysiology
1
2
Anatomy
3
Varied anatomy
haustra of colon
Length: 5~10 cm, narrow lumen
4
Epidemiology
The most common acute abdomen disease The incidence of appendectomy appears to
This triggers somatic pain fibers, innervating the peritoneal structures
Typically causing pain in the RLQ
13
Pathophysiology
The change in stimulation form visceral to somatic pain fibers explains the classic migration of pain in the periumbilical area to the RLQ seen with acute appendicitis.
9
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.
14
Pathophysiology
Exceptions exist in the classic presentation due to anatomic variability of the appendix
Appendix can be retrocecal causing the pain to localize to the right flank
be declining due to more accurate preoperative diagnosis. Despite newer imaging techniques, acute appendicitis can be very difficult to diagnose.
5
Pathophisiology
11
Pathophysiology
Initial luminal distention triggers visceral afferent pain fibers, which enter at the 10th thoracic vertebral level.
This pain is generally vague and poorly localized.
6
Pathophysiology
Acute appendicitis is thought to begin with obstruction of the lumen
Obstruction can result from food matter, adhesions, or lymphoid hyperplasia
Simple appendicitis Suppurative appendicitis Gangrenous appendicitis Perforated appendicitis Peritonitis Abscess around the appendix Mucocele of appendix
microbes：Ecoli, streptococcus, Pseudomonas, anaerobe
10
Etiology
Increased pressure also leads to arterial stasis and tissue infarction
End result is perforation and spillage of infected appendiceal contents into the peritoneum
Appendix is twisted, and Lumen of appendix is narrow, result in obstruction
Mucosal secretions continue to increase intraluminal pressure
7
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%）pendix artery has no branches, is easily to be obstacled
Pain is typically felt in the periumbilical or epigastric area.
12
Pathophysiology
As inflammation continues, the serosa and adjacent structures become inflamed
15
Pathophysiology
1
2
Anatomy
3
Varied anatomy
haustra of colon
Length: 5~10 cm, narrow lumen
4
Epidemiology
The most common acute abdomen disease The incidence of appendectomy appears to
This triggers somatic pain fibers, innervating the peritoneal structures
Typically causing pain in the RLQ
13
Pathophysiology
The change in stimulation form visceral to somatic pain fibers explains the classic migration of pain in the periumbilical area to the RLQ seen with acute appendicitis.
9
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.
14
Pathophysiology
Exceptions exist in the classic presentation due to anatomic variability of the appendix
Appendix can be retrocecal causing the pain to localize to the right flank
be declining due to more accurate preoperative diagnosis. Despite newer imaging techniques, acute appendicitis can be very difficult to diagnose.
5
Pathophisiology
11
Pathophysiology
Initial luminal distention triggers visceral afferent pain fibers, which enter at the 10th thoracic vertebral level.
This pain is generally vague and poorly localized.
6
Pathophysiology
Acute appendicitis is thought to begin with obstruction of the lumen
Obstruction can result from food matter, adhesions, or lymphoid hyperplasia
Simple appendicitis Suppurative appendicitis Gangrenous appendicitis Perforated appendicitis Peritonitis Abscess around the appendix Mucocele of appendix
microbes：Ecoli, streptococcus, Pseudomonas, anaerobe
10
Etiology
Increased pressure also leads to arterial stasis and tissue infarction
End result is perforation and spillage of infected appendiceal contents into the peritoneum
Appendix is twisted, and Lumen of appendix is narrow, result in obstruction
Mucosal secretions continue to increase intraluminal pressure
7
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%）pendix artery has no branches, is easily to be obstacled
Pain is typically felt in the periumbilical or epigastric area.
12
Pathophysiology
As inflammation continues, the serosa and adjacent structures become inflamed