Clinical manifestations of appendicitis
Appendix usually stems from a complaint of pain in the umbilicus or periumbilikus associated with vomiting. Within 2-12 hours of pain will turn to the right lower quadrant, which will persist and exacerbated when walking or coughing. There is also keluihan anorexia, malaise and fever that is not too high. Usually there is also constipation, but sometimes diarrhea, nausea and vomiting. At the beginning of the onset of the disease there is no persistent abdominal complaint. But within a few hours of lower abdominal pain will be more
progressive and a careful examination will be indicated by a single point of maximum pain. Light percussion on the right lower quadrant pain can help determine the location. Off the pain and spasms usually appear. If the mark rovsing, psoas and obturator positive, the more convincing diagnosaklinis appendicitis.Complications of Appendicitis
Appendicitis is a disease that rarely subsides spontaneously, but the disease is unpredictable and has a tendency to be progressive and is perforated. Because perforation rarely occurs in the first 8 hours, is safe to do the observation period. Signs of perforation include increasing pain, muscle spasm of the right lower quadrant abdominal wall with a sign of generalized peritonitis or localized abscess, ileus, fever, malaise, leukocytosis more obvious, when perforation with generalized peritonitis or abscess formation has occurred since the client is first come, diagnosis can be established with certainty. If there is generalized peritonitis specific treatment is surgery done to close the perforation origin. While the other acts as a support: bed rest in a medium-Fowler position, mounting NGT, fasting, correction fluids and electrolytes, a sedative administration, administration of antibiotics followed by administration berpesktrum broad antibiotic according to culture, transfusion to address anemia and shock septif intensive treatment, if any. When an appendix abscess will be felt in the right lower quadrant mass that tends to bubble toward the rectum or vagina. Early treatment can be given a combination of antibiotics (eg amplisilin, gentamicin, metronidazole, or clindamycin). With this preparation the abscess will soon disappear and apendiktomi can be done 6-12 weeks later. In the abscess is still progressive drainage should be done immediately. Pelvic abscess area that stands out towards the rectum or vagina with a positive fruktuasi drainage also need to be made. Supuiratif thrombophlebitis of the portal system is rare but is a complication that location. This should be suspected when fever is found sepsis, chills, hepatomegaly and jaundice after a perforated appendix. In this situation is indicated in combination with antibiotic administration ndrainase. Another complication that occurs is an abscess subfrenikus and other intraabdominal sepsis fkal. Intestinal obstruction may also occur due to adhesions.
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