Treatment of appendicitis

Treatment of appendicitis both acute and chronic - only online. In acute appendicitis immediate operation is mandatory regardless of the length of the disease, especially in developed General peritonitis. Only in the stage of infiltration often preferred wait-and-see tactics, because removing immured in spinach process is technically very difficult, accompanied by a great injury, breach occurred separation and the threat of the spread of infection in the abdominal cavity.
The most profitable operation in the first 24 hours: the results are not worse appendectomy made routinely in a cold period of the disease. If from the beginning of the attack has been more than 48 hours and phenomena quickly and surely subside, then rush to surgery is not necessary, since it is already possible presence of infiltration, which is still unable to probe, or illness is limited appendiceal colic. But wait a valid only if the careful, continuous monitoring of hemodynamic changes and opportunities immediately to operate on a patient at the slightest sign of deterioration. In these cases, the prescription of narcotic drugs is particularly dangerous. When flowing, and especially the growing phenomena emergency operation is obligatory in any period from the beginning of the attack. The same applies to cases where signs of the coming improve questionable.
The patient, without surgery suffered an attack of acute appendicitis, subject to planned interventions in a cold period." If the attack was followed by the formation of infiltration, appendectomy may be made not earlier than one month after the final disappearance of infiltration by normalization of the testimony. However, to postpone the operation of long term should not be given the possibility of a second acute attack. In chronic appendicitis patient should be offered elective surgery, once the diagnosis is established.
With a dense, sharply demarcated and favorably current infiltrate conservative treatment. It boils down to the appointment of strict bed rest and antibiotics. Laxatives, threatening violation occurred distinguishing certainly is contraindicated. The appointment of laxatives is unacceptable not only when infiltrates, but in any stage of acute appendicitis and in General for acute pain in the abdomen, raising suspicion of appendicitis, intestinal obstruction, or ectopic pregnancy, and so on, you Need to remember that no one has ever died from only delay chair for several days, but many died as a result of attempts to call his castor oil, bitter salt, etc., If there safely current infiltration and the absence of the chair for 3-4 days appoint mikroklizm - oil or hypertension (10%) sodium chloride solution, of not more than 100-150 ml Question about using a heating pad or bladder with ice should be addressed by the patient, depending on painkiller effect of these funds. Usually in the early days of education infiltrate works better cold, then warm. You cannot assign the drug is not yet resolved the question about the operation, as well as the introduction of morphine or morphine can complicate diagnosis (especially in the early stages of the attack) or disguise coming deterioration when infiltrate. If you enter a painkiller necessary before a long and difficult transportation of the patient in surgery institution, in an accompanying document must be indicated time (hours and minutes), and the dose of the drug.
When the abscess formation appendiceal infiltrate shows-opening it, which should be made possible not through the abdominal cavity. Iliac ulcers open side vnebrachnyi slit, pelvic - through the rectum (see Douglas abscess). If it is impossible vnebrachnogo access abscess open, carefully isolating it tampons free from the abdominal cavity. As a rule, it is necessary to be limited only to remove festering accumulation and tamponade, as the search process in these cases, invalid, and he only occasionally found in the oral ulcer.