Surgical treatment of appendicitis

Surgical treatment of appendicitis:

Once the diagnosis of acute appendicitis is confirmed, appendectomy should be performed early. Early surgery refers to surgical removal when the appendix is ​​still blocked or only congested and edematous. At this time, the operation is simpler and there are fewer postoperative complications. If surgery is performed after suppuration, gangrene or perforation, it will not only be difficult to operate but also significantly increase postoperative complications. The use of antibiotics before surgery helps prevent postoperative infection.

The surgical options for different clinical types of acute appendicitis are also different.

1Acute simple appendicitis: appendectomy, primary suture of the incision. Laparoscopic appendectomy can also be performed in units with conditions.

2 Acute suppurative or gangrenous appendicitis: appendectomy. If there is pus in the abdominal cavity, it should be carefully removed, and the abdomen should be closed after the pus is soaked with wet gauze. Pay attention to protecting the incision and suturing it in the first stage.

3. Perforated appendicitis: The right lower abdomen is incised through the rectus abdominis muscle, which is conducive to intraoperative examination and diagnosis, removal of the appendix, removal of abdominal pus or flushing of the abdominal cavity, and placement of abdominal drainage according to the situation. During the operation, pay attention to protecting the incision, flushing the incision, and suturing. Pay attention to observing the incision after surgery, and drain it in time when it is infected.

4. Peri-appendiceal abscess: When the appendix abscess has not ruptured or perforated, it should be treated as acute suppurative appendicitis. If the appendix perforation has been wrapped around the appendix to form an abscess, and the condition is stable, antibiotic treatment or combined Chinese medicine treatment should be used to promote the absorption and regression of the abscess. Puncture, pus extraction or catheter drainage can also be performed under the guidance of ultrasound. If the abscess expands and the trend is unrestricted, a B ultrasonography examination should be performed first to determine the incision site, and then surgical incision and drainage should be performed. The incision and drainage are mainly drainage. If the appendix is ​​convenient to show, the appendix should also be removed. If there is gangrenous perforation at the root of the appendix, it is feasible to close the cecal wall of the appendix opening. Strengthen supportive treatment after surgery and use antibiotics reasonably.