Appendix ischemia congestion

Introduction The appendix artery is the terminal branch of the ileo-arterial artery, which is a terminal artery. Therefore, due to the stimulation, the ischemic or hyperemic abnormality of the appendix is often caused. Mild swelling of the appendix, congestion of the serosa surface, loss of normal luster and a small amount of fibrinous exudate, all layers of tissue have congestion, edema and neutral polynuclear leukocyte infiltration. Significantly, small ulcers may still appear on the mucosa, and a small amount of inflammatory exudate may be present in the lumen.

Cause

The appendix artery is the end of the ileo-arterial artery and belongs to the superior mesenteric artery. The source is the abdominal aorta, which is the main cause of ischemic congestion of the appendix.

an examination

Related inspection

Urine routine blood routine

1, blood phase: the total number of white blood cells can be increased to l. 2 ~ 14,000 / mm3; and neutrophils accounted for 85% ~ 95%, such as neutrophils to more than 85% more than the reaction is heavier, sometimes visible Poisoning particles. However, there are also cases in which individual appendicitis patients do not rise significantly from the cells.

2. For patients with difficult cases, abdominal puncture should be performed. If there are pus cells by microscopic examination, they can be diagnosed.

3, CT can directly display the appendix and surrounding soft tissue and inflammation. 4, B-ultrasound B ultrasound under normal appendix no image display, more than 6mm can determine the diagnosis of appendicitis, the width of the appendix cavity increases, showing the size of the abscess around the appendix.

Differential diagnosis

The diagnosis should be differentiated from the following symptoms:

1. Ischemic necrosis of the appendix wall The so-called ischemic necrosis of the appendix wall is the continuous increase of intracavitary pressure, the wall of the appendix is also compressed, the venous return is blocked, the wall of the appendix is edema and ischemia, and the bacteria can penetrate into the abdominal cavity. In severe cases, the arteries are also blocked, causing necrosis of the appendix. The location of the luminal obstruction is mostly at the base of the appendix, but also in the middle and distal segments of the appendix.

2. Abscess around the appendix The abscess around the appendix is the result of a purulent appendix or a perforated appendix. The pus is confined to the appendix and forms an abscess. Due to excessive adhesion, the operation is difficult and the appendix is difficult to remove, and the abdominal cavity is destroyed. Function to spread inflammation, traditionally conservative treatment or abscess drainage, but the symptoms can be relieved under the anti-inflammatory treatment of western medicine, it takes a long time, the light often has persistent sequelae and disease, and the severe one may have abscess Collapse caused by peritonitis, residual peritoneal abscess, suppurative portal phlebitis and other serious complications.

Acute appendix abscess is one of the main complications of acute appendicitis. Acute appendicitis is not treated in time. When the appendix has exudation, necrosis and perforation, the omentum and the nearby intestine will tend to surround the appendix. The swelling is not a cavity. It is often an inflammatory mass of omentum and small intestine. Patients have more chills, high fever, increased white blood cell count, and a mass in the right lower quadrant. The border is unclear, tenderness is obvious, and adhesion to surrounding tissues.

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