Perityphlitic abscess
| Classification according to ICD-10 | |
|---|---|
| K35.1 | Acute appendicitis with peritoneal abscess |
| ICD-10 online (WHO version 2019) | |
The perityphlitische abscess is a appendicitis , in which an inflamed appendix in (covered) Perforation an abscess has formed. The abscess formation hides some of the symptoms of appendicitis , especially the severe pain associated with it in the right lower abdomen and most of the pain provoked in the diagnosis. In addition to a general malaise with fever (up to approx. 39 ° C), you may only feel a slight pressure pain in the area of the appendix. The disease is life-threatening because the perityphlitic abscess usually leads to life-threatening consequences such as peritonitis or sepsis sooner or later . However, if operated in good time, the prognosis is good.
Diagnosis
The diagnosis of "perityphlitic abscess" is made during the medical examination. The perityphlitic abscess can remain undetected during sonography (ultrasound). A reliable diagnosis is possible using computed tomography . In the blood test, the values for leukocytes and CRP are significantly increased, but not if the abscess is still closed.
therapy
The therapy consists of an operation with opening of the abdominal cavity, during which the appendix including abscess and already infected adjacent intestinal parts are removed. Antibiotics are also given postoperatively to remove any remaining infectious germs and to prevent secondary infections as a result of the operation.
Alternatively - for example in patients in a very poor general condition - CT - or sonography -controlled drainage can be inserted into the abscess formation and the abscess can be emptied. In the following days are intravenous antibiotics administered to allow the decay of the inflammation. Only then does the operational rehabilitation take place. Usually it comes to largely inconsequential healing, in some cases retain adhesions in the abdominal cavity, leading to a postoperative obstruction may lead (intestinal obstruction). Another occasional complication is the formation of an enterocutaneous fistula (connection between the intestine and the surface of the skin). This can close spontaneously after a while or is closed surgically.
See also
Typhlitis , an inflammation of the appendix in immunocompromised patients.
Individual evidence
- ↑ S. Feuerbach: Handbook of diagnostic radiology: Gastrointestinal system. Springer, 2006, ISBN 3-540-68472-7 , p. 354. (online)