急性阑尾炎英文.pptVIP

Acute appendicitis WangJun The second general surgical department People s hospital of yuxi city Outlines ? General considerations ? Historical perspective ? Anatomy ? Pathophysiology ? Clinical findings ? Diagnosis ? Treatment General considerations ? About 8% of people in Western countries have appendicitis at some time during their life, with a peak incidence between 10 and 30 years of age . ? Acute appendicitis is the most common general surgical emergency.(10%) General considerations ? Acute appendicitis has protean manifestations. ? It may simulate almost any other acute abdominal illness and in turn may be mimicked by a variety of conditions. ? Progression of symptoms and signs is the rule — in contrast to the fluctuating course of some other diseases. Historical perspective ? Willard Packard performed the first surgery in 1867. ? In 1886,Reginald Fitz described the characteristic,clinical findings and pathology of the disease,identified the appendix as the primary cause of right lower quadrant inflammation. ? Fitz coined the term appendicitis and recommended early surgical treatment Historical perspective ? In 1889, Chester McBurney described characteristic migratory pain as well as localization of the pain along an oblique line from the anterior superior iliac spine to the umbilicus. ? In 1894, McBurney described a right lower quadrant muscle-splitting incision for removal of the appendix. Historical perspective ? In the 1940s,the mortality rate from appendicitis improved with the widespread use of broad-spectrum antibiotics. ? In 1982, Laparoscopic appendectomy was first reported by the gynecologist Kurt Semm but has only gained widespread acceptance in recent years. Anatomy ＆ physiology ? The base of the appendix is located at the convergence of the taeniae(3) of colon. ? This anatomic relationship facilitates identification and location of the appendix at