Wednesday, February 11, 2015

Appendicitis 5 inveatigation treatment


INVESTIGATION
- A blood count to establish rise in white cell count.
- A urine examination to eliminate pus cells and RBC.
- A plane X-ray abdomen to eliminate stone in urinary tract.

5. TREATMENT
*  The  best treatment for all patients of early appendicitis  is
   appendectomy.

*  The  patients  with early non-fixed mass operation  should  be
   advised  especially  in children, pregnant women  and  elderly
   patients.

*  Patients  with evidence of perforated appendix  and  spreading
   peritonitis  too need to be operated early for the purpose  of
   removing the appendix and drainage of the peritoneal cavity.

*  Patients with fixed mass in the right iliac fossa.
   If,  when  the  patient is first seen, and  the  symptoms  are
   subsiding  a well localised mass is palpable in the region  of
   the right iliac fossa.  It is reasonable to start the  patient
   on   antibiotics,  snalgesics  and  nasogastric  suction   and
   intravenous  feeding  regime till the mass  subsides  and  the
   patients can be taken up for surgery six to eight weeks later.

*  All  the  categories  of the  patients  mentioned  above  will
   require varying periods of fluid replacement  and  nasogastric
   suction  so  that  their  fluid  and  mutritional  balance  is
   maintained and they may be able to stand the operative  trauma
   with the minimum risk in the post-operative period.

*  The patients will also require a frequent re-examination while
   under conservative resuscitative measures to detect early  any
   change in the local and general progress of the disease.

*  Early  surgical  intervention can be restorted to at  any  time
   provided the circumstances demand it.

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