Abscess around the appendix

Introduction The abscess around the appendix is the result of a purulent appendix or a perforated appendix. The pus is confined to the appendix to form an abscess. Due to excessive adhesion, the operation is difficult and the appendix is difficult to remove, and the abdominal defense function is destroyed to spread the inflammation. In the traditional sense, there are many conservative treatments or abscess drainage, but the symptoms can be alleviated under the anti-inflammatory treatment of western medicine. It takes a long time. The lighter often has persistent sequelae and diseases. In severe cases, there may be abscess ulceration and full peritonitis. Peritoneal residual abscess, suppurative portal phlebitis and other serious complications.

Cause

Acute appendicitis, purulent gangrene or perforation, if this process progresses slowly, the omentum can be moved to the right lower abdomen, wrapping the appendix and forming adhesions, forming an inflammatory mass or abscess around the appendix. Abscess around the appendix is mainly qi stagnation, blood stasis, phlegm heat or hoarding into a block, is one of the symptoms of infection around the appendix, is a purulent appendix or pus produced by perforation of the appendix, is confined The result of an abscess around the appendix.

an examination

Related inspection

Gastrointestinal CT examination of gastrointestinal imaging fiberscope

Abscess around the appendix is a common pathological type of acute appendicitis. Clinically, if there is metastatic right lower quadrant pain or right lower quadrant pain, right lower quadrant and a tender border with a clear border, the abscess around the appendix should be considered first. B-ultrasound suggests that the right lower quadrant mixed mass is valuable for the diagnosis of this disease.

Differential diagnosis

Differential diagnosis:

1, tuberculous peritonitis complicated by intestinal obstruction: there are clinical manifestations of appendicitis or abscess around the appendix, such as chronic abdominal pain, bloating, paroxysmal abdominal pain, combined with mixed infection is more like the abdominal signs of acute appendicitis. If you carefully ask about your medical history and physical examination, you will find that there are some cases of night sweats, fatigue, abdominal pain, and abdominal tenderness. The possibility of tuberculous peritonitis should be considered at this time. It needs to be excluded by X-ray chest radiography and abdominal wear.

2, acute pelvic inflammatory disease, right ovarian cyst pedicle torsion: female patients newly diagnosed with acute appendicitis should try to rule out the possibility of some gynecological diseases, menstrual abnormalities, vaginal discharge, pubic symphysis and tenderness involved in the right lower abdomen should think of gynecological diseases The possibility is that gynecological consultation is needed, and gynecological diseases are excluded by means of necessary auxiliary examinations.

3, gastric ulcer with gastric perforation: fasting stomach perforation, perforation blocked by food debris, when the perforation is small, 6 ~ 12 h after the formation of the right lower abdomen localized peritonitis, the upper abdomen has a light peritonitis, sometimes no underarm free gas Especially like metastatic right lower abdominal pain in acute appendicitis, patients with newly diagnosed acute appendicitis should understand the history of stomach disease. Elderly patients with weight loss should pay special attention to the history of stomach disease, carefully examine the signs of upper abdomen, and identify them by abdominal perforation and abdominal wear. .

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