Appendicular infiltration

Surgical diseases

The appendicular infiltrate is a conglomerate of inflammatory organs and tissues, caused by acute destructive appendicitis. The large omentum, mesentery and loops of the small intestine limit the inflammatory process. 3-4 days after the formation of the infiltrate inflammatory changes are expressed so sharply that it is not possible to divide the infiltrate, but if such attempts are made, this may result in rupture of the intestinal wall.

Usually 3-5 days after the onset of pain in the right iliac region, their intensity decreases slightly. Temperature subfebrichnaya. Upon examination, the tongue is moist, coated. The abdomen is soft, the stiffness of the muscles and moderate soreness in the right iliac region are determined, the painless dense without rigid boundaries is palpated here. The place may be marked by weakly positive symptoms of irritation of the peritoneum. In the analysis of blood-leukocytosis with a shift of the formula to the left. With a survey X-ray study of the abdominal cavity, the pneumatosis of the intestinal loops adjacent to the infiltrate is determined.

Outcomes of appendicular infiltrate:

  1. Resorption under the influence of conservative treatment;
  2. After some reduction in pain, again the pain syndrome increases, the temperature increases, the local gain and the increase in the zone of soreness with the increase and spread of peritoneal symptoms. In the analysis of blood, the increase in leukocytosis and the shift of the formula to the left. Such a clinical picture is caused by insufficient barrier function of the infiltrate with an increase in peritonitis. Operative intervention-laparotomy under general anesthesia is necessary, only after laparotomy can the question of the nature of the operation be resolved;
  3. Abscessing of appendicular infiltrate - see Abscess.

Treatment of appendicular infiltrate is conservative: mechanically sparing diet, cold on the stomach, broad-spectrum antibiotics, metronidazole. After 3-6 months (during this period there is a complete resolution of the infiltrate), a routine appendectomy is shown, which is expedient to carry out under general anesthesia, since it is often accompanied by significant technical difficulties.