Appendicular infiltrate

Causes, symptoms and treatment of appendicular infiltrate

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What is appendicular infiltrate?

Infiltration in the appendiceal shape, is an acute complication of appendicitis is an intermediate stage lasting up to 5 days. It represents the accumulation of altered tissue inflamed, which are tightly interconnected. This conglomerate includes directly the Appendix and surrounding education: the small intestine, the omentum, the caecum. Appendicular infiltrate is formed on the 3-4 day from the start of the disease. In this case the right iliac fossa (sometimes another region) takes the formation of a limited type, tight, immobile and painful when pressed.

Symptoms of appendicular infiltrate

The lack of timely surgical intervention may lead to purulent and infiltrative process in the right iliac region, where a cluster of organs, including the Appendix, the tissue which are inflamed. Observations record the presence of appendicularia abscess in 15% of patients who were operated on the basis of gynecological diseases, and the secondary involvement of the Appendix in suppurative process in the presence of gynecological abnormalities according to some estimates is about 10%.

The disease begins with a sudden pain paroxysmal character, which at the initial stage is localized in the navel. While there is no characteristic connection of the disease with risk factors forwhich develop inflammation of internal genital organs. All carefully collected history allows you to initially set the pathology from surgery. On the fourth day after acute attack, or later, if used anti-inflammatory or antibacterial treatment, formed appendicular infiltrate.

After a few days the pain becomes less, but the toxicity of endogenous form is saved. Showing a consistently increased body temperature to 37.8°C with a moderate increase in heart rate and leukocytosis. By palpation can be defined in the iliac region on the right side, infiltration, which has a firm consistency with well-defined borders. However, it can dissolve in 30-40 days, but most likely it is an abscess.

In the worst case the patient's condition is deteriorating rapidly, and there are all the symptoms of purulent inflammation: sharp fluctuations in body temperature, chills, increasing and a sharp pain of infiltration of local fluctuations, uneven texture.

Diagnosis of appendicular infiltrate

Diagnosis of appendicular infiltrate is to conduct a medical examination. Further diagnosis can be done after the ultrasound. By her conduct in the iliac region on the right side reveal an infiltrate that has irregular shape echo-positive education without a clear capsule, it is determined the presence of low echogenicity relative to adjacent tissue. The examination may reveal abscess formation structure, infiltration and to fix the cystic formation with a clear capsule and liquid contents, which means accumulation of pus.

Treatment of appendicular infiltrate

Treatment of appendicular infiltrate is conservative, but should be performed only in a hospital. It consists of antibiotic therapy, the diet, restriction of physical activity. Surgical treatment is not required. As a rule, appendicular infiltrate resolved after 2 weeks of treatment.

Emergency surgery is performed only when certain indications: perforation of the abscess into the bladder or the peritoneal cavity, and septic shock. Operation of the emergency order with the development of purulent process has technical difficulties and could face the prospect of the development of septic shock. Technically the operation is the same, but in particularly serious conditions patients undergo the intervention of the palliative kind, there is drainage of the abscess, or also of the cecum, and in the period of remission is surgeryreconstruction. It is therefore important to recognize and treat appendicular infiltrate.

A thorough collection of information about the symptoms of the disease provides a basis to make an accurate diagnosis of surgical disease before the operation. Advanced cases even when the cross section of the womb cause difficulty in determining the root cause. The tactics of the operation remains the same, in any case, appendectomy is performed and corresponds to the case of gynecological surgery, with further drainage of the abdominal cavity.