阑尾炎英文演示文稿.pptVIP

Central-South University Central-South University 阑尾炎英文演示文稿 当前1页，共35页，星期一。 当前2页，共35页，星期一。 Anatomy 当前3页，共35页，星期一。 Varied anatomy Length: 5~10 cm, narrow lumen haustra of colon 当前4页，共35页，星期一。 Epidemiology The most common acute abdomen disease The incidence of appendectomy appears to be declining due to more accurate preoperative diagnosis. Despite newer imaging techniques, acute appendicitis can be very difficult to diagnose. 当前5页，共35页，星期一。 Pathophisiology Simple appendicitis Suppurative appendicitis Gangrenous appendicitis Perforated appendicitis Peritonitis Abscess around the appendix Mucocele of appendix 当前6页，共35页，星期一。 Pathophysiology 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 Mucosal secretions continue to increase intraluminal pressure 当前7页，共35页，星期一。 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%） 当前8页，共35页，星期一。 Artery The appendix artery has no branches, is easily to be obstacled 当前9页，共35页，星期一。 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. microbes：Ecoli, streptococcus, Pseudomonas, anaerobe 当前10页，共35页，星期一。 Etiology Increased pressure also leads to arterial stasis and tissue infarction End result is perforation and spillage of infected appendiceal contents into the peritoneum 当前11页，共35页，星期一。 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. P