Literature Review : Complicated Appendicitis Essay

ABDOMEN: The lung basis appeared unremarkable. The liver, spleen, gallbladder, adrenals, kidneys and pancreas and abdominal aorta appeared unremarkable. The bowels seen on the study appeared thickened. Dilated appendix seen constant with acute appendicitis. Osseous structures of the abdomen appeared unremarkable. No free air was seen.

On later reflection I realized I could have though about interstitial cystitis, appendicitis and renal calculi. My multiple hypotheses for this patient are presented in Table 1.

When first attempting anything, there is always going to be some sort of pressure to perform well. Dr. William Nolen, in his short story, “The First Appendectomy”, clearly expresses the stress he endures while performing his first surgery to the reader by his descriptions of the surgery. When he begins the surgery, he shows his first sign of stress, saying “I was ready to begin. Suddenly my entire attitude changed. A split second earlier I had been supremely confident; now, with the knife finally in my hand, I stared down at Mr. Polansky’s abdomen and for the life of me could not decide where to make the incision” (Nolen 147). Though Nolen was confident he could handle the surgery with ease, he ends up uncertain of what he is doing. He is straining

When there is a problem in the colon, and these cells are inflamed and infected, they

Abdomen: The lipases appeared unremarkable. The liver, spleen, gallbladder adrenals, kidneys, pancreas and abdominal aorta appeared unremarkable. The bowels seen on the study appeared thickened. Dilated appendix seemed consistent with acute appendicitis. All the structures of the abdomen appeared unremarkable. No free air was seen.

The inflammation in diverticulitis is believed to be the result of fecal material that gets trapped in a diverticulum. The resulting fecal stone, or fecalith, causes pressure and necrosis of the diverticulum. The inflammation progresses and perforates into the mucosa of the colon. A small perforation is easily treated with antibiotics. A large perforation may wall off and create an abscess which can erode into nearby structures such as the small bowel or bladder, anterior abdominal wall, and fecal peritonitis can occur. (textbook)

The Disease have always been cured through the hospital system, medication, however, recently it has begun a movement stated we should depend less on our medication. Base on statics publish for the center for disease as of 2012, about half of all adults—117 million people—had one or more chronic health conditions. One of four adults had two or more chronic health conditions. Among those disease diversities is one the disease. Diverticulitis is a disease when pouches form in the wall of the colon. If these pouches get inflamed or infected, it is called diverticulitis. Therefore, diverticula have always been a serious disease in the United States; thus there has been several of a reason for causing the disease. Research has dictated

Pathophysiology: Diverticulitis, is characterized by inflamed diverticuli and increased luminal pressures that cause erosion of the bowel wall and thus microscopic or macroscopic perforation into the peritoneum. A localized abscess develops when the

HISTORY- EPIDEMIOLOGY: Diverticulitis is an intestinal inflammation occurring as a complication to the disorder of diverticulosis. The global epidemiology is associated with the western culture diet, being far more common in industrialized countries like the United States, Canada, Australia and the United Kingdom, and much less prevalent in Asia and Africa. These two conditions were rare in the 18th century and appear to be linked to the reduction of fiber in flour due to the development of roller mills that replaced grist mills in the late 1800’s. Roller mills were a more efficient method of refining wheat into flour; however this resulted in the destroying or removal of most of the fiber from the grain. This

I was happy that I managed to rule out any distinct causes of the abdominal pain by performing the examination to collect data, analyse it, and use the results to make an appropriate decision (Schon, 1984). However, had I performed the examination without assistance I may not have gained all the information required to confirm diagnosis, as I did forget some aspects.

5. Palpation of liver – edge not palpated, percussion approximated at 8 cm in Right mid clavicular line. Spleen non palpable.

If bleeding is slow, you may be allowed to go home. If there is a lot of bleeding, you will need to stay in the hospital for observation.

The clinical presentation is a severe right lower quadrant pain, nausea, vomiting, loss of appetite, fever, or constipation. Therefore, during a good physical examination, it is important to rule out by looking for positive psoas signs and rebound tenderness. Appendicitis is a medical emergency which requires immediate surgery to remove the appendix before burst, or eventually perforate into the abdominal cavity that can be fetal if left untreated (Singer, Thode & Singer, 2016).

However, some patients develop peritonitis due to continuous fluid extravasation, higher bacterial load of the upper gastrointestinal tract and impaired spontaneous sealing of the perforation. These observations were the basis for the development of conservative treatment.

With this examination the doctor is ruling out the possibility of appendicitis or other potential causes of severe abdominal pain by carefully applying pressure to different areas of the patient’s abdomen. In the case of pyelonephritis the abdominal exam should be positive for suprapubic tenderness and the associated discomfort should be from mild to moderate. Pain reported in areas other than in the suprapubic area is suggestive of another diagnosis. Patients often complain about flank or costovertebral angle (CVA) tenderness and is typically found over the involved kidney (unilateral) however discomfort bilaterally can be present. Patient history would be the next likely indicator of pyelonephritis and the doctor may wish to follow up with laboratory tests which are used to identify any conditions that may complicate the prognosis and determine whether or not the patient should be admitted or treated as an