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Indications to appendectomy at not changed shoot - appendectomy Complications

Table of contents
Appendectomy complications
Reasons of postoperative complications 2
Reasons of postoperative complications 3
Reasons of postoperative complications 4
Indications to appendectomy
Indications to appendectomy - appendicular infiltrate
Indications to appendectomy at not changed shoot
Indications to appendectomy at an appendicism
Indications to appendectomy - postoperative supervision
Complications from a wound
Complications from a wound, the choice of methods of treatment
Complications from a wound - the general treatment
Complications from a wound - eventration
Complications from a wound - use of antibiotics for prevention of early complications
Early complications from an abdominal cavity
Peritonitis
Diffuse peritonitis
Diffuse peritonitis - a peritoneal dialysis
Diffuse peritonitis - an intestines peristaltics
Infiltrates and abscesses of an abdominal cavity
Abscesses of an abdominal cavity
Abscesses interloopy and right ileal area
Subphrenic abscesses
Phlegmons of retroperitoneal cellulose
Acute intestinal impassability
Acute postoperative pancreatitis
Complications from cardiovascular system
Thromboembolism of a pulmonary artery
Myocardial infarction, pylephlebitis
Fibrinferments and embolisms of mesenteric vessels
Prevention of tromboembolic episodes
Complications from a respiratory organs
Complications from an urinary system
Late complications from an abdominal wall
Recognition of inflammatory "tumors" of a front abdominal wall
Origins of postoperative hernias
Late complications from an abdominal wall - keloid cicatrixes
Late complications from abdominal organs
Infiltrates and abscesses of an abdominal cavity
Inflammatory "tumors" of an abdominal cavity
Intestinal fistulas
Adhesive desease
The recommended literature

Appendectomy at not changed shoot — more dangerous intervention, than at appendicitis as occurs against the serious illness simulating appendicitis. According to P.E. Beylin (1966), in the analysis of a lethality it is established that 15,2% after appendectomy of changes in a shoot had no dead, and the death occurred from other diseases (nonspecific ulcer colitis, pneumonia, an illness Krone etc.).
In this regard we consider that each removal of a worm-shaped shoot has to be reasoned. It is necessary to condemn categorically the appendectomies made "just in case", "on the way" during other interventions. In cases when during intervention concerning assumed acute or an appendicism other pathology is found, carrying out appendectomy is a gross blunder.
It is necessary to recognize that diagnosis of an appendicism presents the known difficulties. Objective symptoms, unfortunately, are indistinct, and the surgeon always finds them only at research of the patient. We paid attention that at the directed poll of patients and research of an abdominal cavity at undergone inspection, even transferred appendectomy in the past, it is possible to reveal also the morbidity in the right ileal area arising independently or at its palpation and morbidity in Mac-Burney's points, Lantsa, Kummel, positive symptoms of Obraztsov etc. Therefore the inexperienced doctor, having aimed to establish the diagnosis of an appendicism, will always find the corresponding symptomatology and will confirm the hypothesis made by it. Carried out after this an operative measure, from the point of view of the operating surgeon, it will be justified as macroscopically it will find appendicism signs, taking for pathological changes ". . any operational find — a long or short shoot, commissures in this area, existence of fecal stones, worms etc. When do not find anything, speak about velvety mucous, a thickening of a wall and about many it that is not caught even by a microscope".
Additional methods of research, unfortunately, are indistinct and do not allow to catch those minor changes which can be at an appendicism. At a blood analysis at most of patients it is not possible to establish any shifts in its indicators. Some authors attach significance to X-ray inspection (N. G. Sosnyakov and K. N. Lazareva, 1961; L. D. Taranenko, A.S. Tamarkin, A. I. Oberemchenko, 1969, etc.). Radiological signs of an appendicism are also very indistinct. A number of researchers specify that at an appendicism not filling with the contrast mass of a worm-shaped shoot which in usual conditions it is filled in 70 — 80% of cases (D. Bogatin) is characteristic. Others, on the contrary, specify that chetkoobrazny filling and a delay of a contrast agent in a worm-shaped shoot — an appendicism sign (3. Marzhatka, 1967, etc.) . According to D. Bogatin, on the basis of radiological inspection it is possible to judge the anatomic provision of a worm-shaped shoot, its size, a relief of a mucous membrane, a peristaltics, degrees of admission and emptyings, and also its smeshchayemost or fixing. However all these signs cannot be considered pathognomonic for an appendicism and can be taken into consideration only in total with clinical.



 
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