7/21/2019 Literature Review App Bdah Sukabumi

1/6

LITERATURE REVIEW

ACUTE APPENDICITIS

FUNCTION AND ANATOMY

Lymphoid tissue appeas i! the appe!di" # $ee%s a&te 'ith( The !um'e o& &o))i*)es

pea%s at #++ 'et$ee! a,es -# a!d #+ yeas( Se*etoy immu!o,)o'u)i!s ae podu*ed as pat

o& ,ut.asso*iated )ymphoid tissues to pote*t the mi)ieu i!teio( Appe!de*tomy does !ot

pedispose to 'o$e) *a!*e o a)te the immu!e system( The appe!di" is use&u) 'ut !ot

i!dispe!sa')e( The 'ase aises &om the posteomedia) aspe*t o& the *e*um/ $hee thee

tae!iae *o)i meet( The )e!,th a!d )o*atio! o& the &ee e!d ae 0aia')e1 pe)0i*/ eto*e*a)/ o

eithe )o$e 2uada!t( Co!,e!ita) de&e*ts ae ae a!d *)i!i*a))y i!si,!i&i*a!t(

INFLAMMATION1 ACUTE APPENDICITIS

I!*ide!*e Most *ommo! a*ute su,i*a) *o!ditio! o& the a'dome!( Most &e2ue!t i!

the se*o!d a!d thid de*ades3 paa))e)s amou!t o& )ymphoid tissues i! appe!di"( Moe

*ommo! i! ma)es/ espe*ia))y dui!, pu'eta) yeas( O0ea)) i!*ide!*e -(41- ma)e

pedomi!a!*e( I!*ide!*e has 'ee! de*)i!i!, i! the )ast se0ea) de*ades(

Etio)o,y a!d Patho,e!esis O'stu*tio! o& )ume! *aused 'y &e*a)ith/ )ymphoid

hypetophy/ i!spissated 'aium/ seeds/ o i!testi!a) $oms( Symptomati* *)osed.)oop

o'stu*tio! de0e)ops 'e*ause o& the *o!ti!ued mu*osa) se*etio! i!to +(-.mL *apa*ity )ume!

a!d 'e*ause o& apid mu)tip)i*atio! o& eside!t 'a*teia o& the appe!di"( Diste!tio! stimu)ates

0is*ea) a&&ee!t pai! &i'es/ podu*i!, 0a,ue/ du))/ di&&use midd)e a!d )o$e a'domi!a) pai!(

Sudde! diste!tio! may *ause peista)sis $ith *ampi!,( Ve!ous pessue is e"*eeded/ a!d

ateio)a i!&)o$ *auses 0as*u)a *o!,estio! o& the appe!di"/ $ith e&)e" !ausea( Seosa)

e!,o,eme!t i!&)ames the paieta) peito!eum $ith shi&t o moe se0ee pai! to the i,ht

)o$e 2uada!t( Mu*osa) *ompomise a))o$s 'a*teia) i!0asio!/ $ith *o!se2ue!t &e0e/

ta*hy*adia/ a!d )eu%o*ytosis( With po,essi0e diste!tio!/ a!timese!tei* i!&a*tio! a!d

pe&oatio! o**u( O**asio!a))y/ episodes o& a*ute appe!di*itis eso)0e i& o'stu*tio! is

e)ie0ed3 su'se2ue!t patho)o,i* e"ami!atio! e0ea)s thi*%e!ed/ s*aed appe!di*ea) $a))(

C)i!i*a) Ma!i&estatio!s Symptoms C)assi* po,essio! o& symptoms i!*)udesa!oe"ia 5a)most a)) ha0e it6/ &o))o$ed 'y *o!sta!t modeate peium'i)i*a) pai! $ith shi&t i!

7/21/2019 Literature Review App Bdah Sukabumi

2/6

789 h to shap i,ht )o$e 2uada!t pai!( Vaia')e positio! o& the tip o& the appe!di" o

ma)otatio! a))o$s 0aia'i)ity i! pai! )o*atio!( Su'se2ue!t episodes o& emesis may o**u

$ith o'stipatio! o diahea/ pati*u)a)y i! *hi)de!(

Si,!s Detemi!ed 'y the positio! o& the appe!di" a!d $hethe uptued( Vita) si,!s

sho$ mi)d ta*hy*adia o tempeatue e)e0atio! o& -:C( Positio! o& *om&ot is &eta) o supi!e

$ith )e,s da$! up/ espe*ia))y i,ht( Positio!a) mo0eme!t *auses pai!( A!teio appe!di"

,i0es ma"ima) te!de!ess/ ,uadi!,/ a!d e'ou!d at M*;u!ey

7/21/2019 Literature Review App Bdah Sukabumi

3/6

a!d ome!tum may eso)0e o may e"pa!d i! *o!tai!ed &ashio! to &om a peiappe!di*ea)

a's*ess o to *ause i!testi!a) o'stu*tio!(

I!*ide!*e Ruptue is pese!t i! -B8#B pe*e!t o& patie!ts at pese!tatio!/ $ith a

hi,he i!*ide!*e i! pediati* a!d ,eiati* a,e ,oups(

Dia,!osis A'domi!a) pai! o**asio!a))y 5o!)y 7 pe*e!t6 )esse!s tempoai)y a&te

uptue 'e*ause o& sudde! e)ie& o& diste!tio!3 i! most patie!ts/ pai! *o!ti!ues u!a'ated( A

te!de/ 'o,,y mass may 'e pa)pa')e o! e*ta) e"ami!atio! i! the i,ht )o$e 2uada!t(

De,ee o& diste!tio!/ i)eus/ &e0e/ ta*hy*adia/ )eu%o*ytosis/ a!d to"i* appeaa!*e paa))e) the

se0eity o& peito!itis( Tempeatue ise a!d de,ee o& )eu%o*ytosis ae ma%ed)y hi,he tha!

$ith simp)e appe!di*itis(

Di&&ee!tia) Dia,!osis That o& the a*ute a'dome!( Peopeati0e dia,!osis o& a*ute

appe!di*itis shou)d 'e =B pe*e!t a**uate depe!di!, o! the )o*atio! o& the appe!di"/ the

)e!,th o& the symptoms/ a!d the a,e a!d se" o& the patie!t(

A*ute Mese!tei* Ade!itis Most o&te! i! *hi)dhood/ e*e!t uppe espiatoy

i!&e*tio!/ ,e!ea)ied )ymphade!opathy(

A*ute ?astoe!teitis ?e!ea))y 0ia) etio)o,y3 asso*iated 0omiti!,/ diahea/*ampi!,/ a!d e)a"atio! 'et$ee! hypepeista)ti* $a0es( Sa)mo!e))a ,astoe!teitis esu)ts

&om i!,estio! o& *o!tami!ated &ood3 histoi*a))y disa')es ,oups o& patie!ts( S( typhosa

i!&e*tio! is ae/ *haa*teied 'y ash/ i!appopiate 'ady*adia/ )eu%ope!ia/ a!d positi0e

stoo) *u)tues(

Diseases o& the Ma)e The diseases that mimi* a'domi!a) pai! ae testi*u)a tosio!/

epididymitis/ a!d semi!a) 0esi*u)itis(

Me*%e)

7/21/2019 Literature Review App Bdah Sukabumi

4/6

appe!de*tomy is i!di*ated to de*ease su'se2ue!t *o!&usi!, symptoms 5!ot do!e i& the

*e*um is i!0o)0ed 'e*ause o& the ,eate is% o& postopeati0e &istu)a6(

Pe&oated Pepti* U)*e Ri,ht ,utte spi))a,e o& uppe ,astoi!testi!a) *o!te!ts $ith

apid sea)i!, o& pe&oatio! *auses pomi!e!*e o& i,ht )o$e 2uada!t symptoms(

Di0eti*u)itis o Pe&oati!, Ca*i!oma o& the Co)o! Re2uies e"p)oatio!( Epip)oi*

Appe!da,itis I!&a*tio! se*o!day to tosio!( Pai! pese!t 'ut !o peito!itis o o'stu*tio!(

Ui!ay Ta*t I!&e*tio! Ri,ht *osto0ete'a) a!,)e te!de!ess a!d 'a*teiuia pese!t(

Uetea) Sto!e ematuia a!d e&eed pai! to s*otum o )a'ia pese!t( Pye)o,aphy

*o!&ims dia,!osis( Pimay Peito!itis Teated $ith a!ti'ioti*s a&te paa*e!tesis sho$s

simp)e ,am.positi0e &)oa( e!o*h.S*h!)ei! Pupua O**us se0ea) $ee%s a&te

stepto*o**a) i!&e*tio!3 asso*iated $ith pupua/ oi!t pai!s/ a!d !ephitis( Yesi!iosis

Ta!smitted 0ia *o!tami!ated &ood3 mimi*s appe!di*itis( Campy)o'a*te eu!i *auses

diahea a!d pai! $ith positi0e stoo) *u)tues( ?y!e*o)o,i* Disodes Pe)0i* i!&)ammatoy

disease/ usua))y 'i)atea)/ asso*iated $ith )o$e pe)0i* pai! a!d *e0i*a) motio! te!de!ess/

o**us peime!stua))y3 ?am stai! o& 0a,i!a) dis*ha,e o&te! sho$s ,am.!e,ati0e

dip)o*o**i( Ruptued ,aa&ia! &o))i*)e mimi*s appe!di*itis $ith spi))a,e o& su&&i*ie!t ')ood

a!d &)uid i!to pe)0is3 o**us at o0u)atio! 5Mitte)s*hme6( O0aia! tosio!/ e!dometiosis/

uptued e*topi* pe,!a!*y( Lapaos*opy is use&u) i! dia,!osis( Othes Foei,!.'ody 'o$e)pe&oatio!s/ mese!tei* 0as*u)a o**)usio!/ i,ht )o$e *hest p)euitis/ a*ute pa!*eatitis/

hematoma o& a'domi!a) $a))(

Se)e*t ?oups

TE YOUN?

Faste po,essio! o& disease $ith hi,h &e0e a!d emesis a!d moe &e2ue!t uptue at

dia,!osis 5-B8B+ pe*e!t6(

TE ELDERLY

De*epti0e)y mi)d *)i!i*a) *ouse $ith i!*eased mo'idity 'e*ause o& hi,he i!*ide!*e

o& *o!*omita!t disease a!d hi,he pe&oatio! ate(

TE PRE?NANT

E"pe*ted &e2ue!*y &o a,e ,oup( Dia,!osis moe di&&i*u)t 'e*ause the appe!di" isdisp)a*ed *epha)ad a!d )atea) 'y ,a0id uteus3 pai!/ !ausea/ a!d )eu%o*ytosis ae *ommo!

7/21/2019 Literature Review App Bdah Sukabumi

5/6

i! !oma) pe,!a!*y/ 'ut a )e&t shi&t i!di*ates a! a*ute po*ess( Mate!a) mota)ity is

!e,)i,i')e( Feta) mota)ity o0ea)) is #8=(B pe*e!t/ #+ pe*e!t $ith appe!di*ea) pe&oatio!

a!d peito!itis( Opeatio! *aies -+8-B pe*e!t is% o& pematue )a'o(

AIDS OR IV INFECTION

C)i!i*a) pese!tatio! !o di&&ee!t/ a)thou,h )eu%o*ytosis may 'e a'se!t(

Cytome,a)o0ius e!teitis/ tu'e*u)osis/ o )ymphoma o& dista) i)eum *a! mimi* appe!di*itis(

Teatme!t

Teatme!t is a)$ays opeati0e 'e*ause the o'stu*ted )ume! $i)) !ot eso)0e $ith

a!ti'ioti*s a)o!e( A*ute appe!di*itis $ithout uptue is teated $ith immediate appe!de*tomy

a&te the medi*a) e0a)uatio! is *omp)ete( Ruptued appe!di*itis $ith )o*a) peito!itis o

ph)e,mo! is opeated o! ea)y a&te esus*itatio! &o &)uid a!d e)e*to)yte )osses( Ruptued

appe!di*itis $ith speadi!, peito!itis e2uies moe e"te!si0e &)uid esus*itatio!/ 'ut the

patie!t shou)d u!de,o opeatio! !oma))y $ithi! 7 h to pe0e!t *o!ti!ued peito!ea)

*o!tami!atio!(

Ruptued appe!di*itis $ith peiappe!di*ea) a's*ess &omatio! may 'e teated a*ute)y

$ith opeatio!/ 'ut this is asso*iated $ith i!*eased mo'idity( I& symptoms ae o& se0ea)days< duatio!/ su'sidi!,/ a!d asso*iated $ith i,ht )o$e 2uada!t mass/ i!itia) !o!opeati0e

theapy $ith &)uid esus*itatio!/ 'o$e) est/ a!d )a,e doses o& a!ti'ioti*s is appopiate/

possi')y i! *o!u!*tio! $ith u)tasou!d.,uided a's*ess dai!a,e( I& 0ita) si,!s/ )eu%o*ytosis/

a!d a'domi!a) si,!s po,ess/ dai!a,e o& a's*ess may 'e i!di*ated/ &o))o$ed 'y

*o!se0ati0e theapy( I!te0a) appe!de*tomy i! 9 $ee%s to 4 mo!ths is ad0ised/ a)thou,h the

o0ea)) ate o& e*ue!*e $ithout i!te0a) appe!de*tomy a!,es &om +84G pe*e!t(

Peopeati0e a!ti'ioti*s )o$e i!&e*tious *omp)i*atio!s/ 'ut the e,ime! is

*o!to0esia)( I& simp)e a*ute appe!di*itis/ thee is !o 'e!e&it to moe tha! #7 h o& a!ti'ioti*s(

I& pe&oated o ,a!,e!ous/ a!ti'ioti*s ae ,i0e! u!ti) the patie!t is a&e'i)e a!d the $hite

')ood *e)) *ou!t is !oma)( Patho,e!s i! a*ute appe!di*itis ae mi"ed *o)o!i* &)oa/ 'oth

aeo'i* a!d a!aeo'i*3 ;a*teoides &a,i)is !eeds *o0ea,e( C)i!damy*i! p)us a!

ami!o,)y*oside o a se*o!d.,e!eatio! *epha)ospoi! e,ime! is popu)a(

7/21/2019 Literature Review App Bdah Sukabumi

6/6

Po*edue I!*isio! shou)d 'e i! the i,ht )o$e 2uada!t &o patie!ts $ith suspe*ted

appe!di*itis( A M*;u!ey 5o')i2ue6 o a Ro*%y.Da0is 5ta!s0ese6 mus*)e.sp)itti!, i!*isio!

is most *ommo!( I& a! a's*ess is suspe*ted/ a )atea) i!*isio! is used to pe0e!t peito!ea)

*o!tami!atio!( A )o$e mid)i!e i!*isio! is used i& the dia,!osis is i! 2uestio!( A )o$e

mid)i!e i!*isio! a)so is used &o ,e!ea) e"p)oatio! 'ut is *o!tai!di*ated $ith a's*ess

'e*ause i!&e*ted mateia) must 'e 'ou,ht thou,h the u!*o!tami!ated peito!ea) *a0ity(

The appe!di*ea) stump *a! 'e simp)y )i,ated o )i,ated $ith puse.sti!, o H.stit*h

i!0esio!( I& appe!di*itis is !ot &ou!d/ the pe)0i* o,a!s a!d emai!i!, a'domi!a) 0is*ea ae

e"p)oed( The mese!tey is e"ami!ed &o )ymphade!itis( The i)eum is u!J &o temi!a)

i)eitis o Me*%e)