Sandbox:Aditya: Difference between revisions
Aditya Ganti (talk | contribs) |
Aditya Ganti (talk | contribs) |
||
Line 157: | Line 157: | ||
*Combination third generation cephalosporins PLUS metronidazole | *Combination third generation cephalosporins PLUS metronidazole | ||
# Ceftriaxone : 1 g IV every 24 hours '''(plus)''' | |||
# metronidazole : 500 mg IV every eight hours | |||
===Surgery=== | ===Surgery=== |
Revision as of 18:21, 15 February 2017
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]
Synonyms and keywords:
Overview
An appendicular abscess is unusual and rare entity and a life threatening complication of acute appendicitis. It is seen in 2-7% of population presenting with appendicitis.
Historical Perspective
Classification
Pathophysiology
The eight functional compartments in the peritoneal cavity include the following:
- Pelvis
- Right paracolic gutter
- Left paracolic gutter
- Right infradiaphragmatic space
- Left infradiaphragmatic space
- Lesser sac
- Hepatorenal space (Morrison space)
- Interloop spaces between small intestine loops
Periappendiceal abscesses from a perforated appendix may develop in the right lower quadrant.
Transmission
The abscesses usually contain a mixture of aerobic and anaerobic bacteria from the gastrointestinal tract.
Differentiating appendicular abscess from other abscess
Disease | Differentiating Signs and symptoms | Specific Lab tests | |
---|---|---|---|
|
|
|
|
|
|||
|
|||
|
|
||
|
|||
|
|||
|
|||
|
|||
|
|||
|
|||
|
|||
|
Epidemiology and Demographics
The lifetime risk of appendicitis is 8.6 % for males and 6.7 % for females; however, the risk of undergoing appendectomy is much lower for males than for females (12 vs. 23 %) and it occurs most often between the ages of 10 and 30, with a male:female ratio of approximately 1.4:1.
Screening
Natural History, Complications, and Prognosis
Natural history
Complications
Prognosis
Diagnosis
History
The key to an efficient and accurate diagnosis is a detailed and thorough history. The following information should be obtained:
- Onset, location, radiation, and duration of pain;
- Aggravating or relieving factors;
- Severity of pain (constant or intermittent);
- Characteristics of the pain;
- History of the pain;
- Association with nausea, vomiting, anorexia, or diarrhea;
- Time of last bowel movement; and
- Recent use of analgesics, narcotics, or antibiotics.
Symptoms
Physical examination
Laboratory findings
Treatment
Medical Therapy
Empiric therapy
- Monotherapy with a beta-lactam/beta-lactamase inhibitor:
- Ampicillin-sulbactam :3 g IV every six hours
- Ticarcillin-clavulanate :3 g IV every four hours
- Piperacillin-tazobactam :3 g or 4.5 g IV every six hours
- Combination third generation cephalosporins PLUS metronidazole
- Ceftriaxone : 1 g IV every 24 hours (plus)
- metronidazole : 500 mg IV every eight hours