Apendicectomie Appendectomy

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Apendicectomie Appendectomy
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O apendicectomie n curs An appendectomy in progress ICD-10-PCS ICD-10-PCS 0DTJ? ZZ 0DTJ?ZZ ICD-9-CM ICD-9-CM 47.0 47.0 MESH MeSH D001062 D001062 O apendicectomie (uneori numite appendisectomy sau appendicectomy) este indepartarea chirurgicala a apendicelui vermiform . An appendectomy (sometimes called appendisectomy or appendicectomy ) is the surgical removal of the vermiform appendix . Aceast procedur este n mod normal face ca o procedur de urgen , n cazul n care pacientul sufer de acut apendicita . This procedure is normally performed as an emergency procedure , when the patient is suffering from acute appendicitis . n absena unor instalaii chirurgicale, intravenos antibiotice sunt folosite pentru a ntrzia sau de a evita instalarea sepsis , este acum recunoscut faptul c multe cazuri, va rezolva atunci cnd tratai perioperatively. In the absence of surgical facilities, intravenous antibiotics are used to delay or avoid the onset of sepsis ; it is now recognized that many cases will resolve when treated perioperatively. n unele cazuri apendicita dispare complet, cele mai multe ori, o face inflamator mas n jurul valorii de apendice, care cauzeaz de flotaie transruptural. In some cases the appendicitis resolves completely; more often, an inflammatory mass forms around the appendix, causing transruptural flotation. Aceasta este o rud contraindicatie la operatie . This is a relative contraindication to surgery . Apendicectomie pot fi efectuate laparoscopic (aceasta se numete chirurgie minim invaziva), sau ca o operaie deschis. Appendectomy may be performed laparoscopically (this is called minimally invasive surgery) or as an open operation. Laparoscopia este adesea utilizat n cazul n care diagnosticul este in dubiu, sau dac este de dorit pentru a ascunde cicatrici n ombilic sau n linia parului pubian. Laparoscopy is often used if the diagnosis is in doubt, or if it is desirable to hide the scars in the umbilicus or in the pubic hair line. Recuperarea poate fi un pic mai repede cu chirurgia laparoscopica, iar

procedura este mult mai costisitoare i consumatoare de resurse decat interventii chirurgicale deschise i, n general, dureaz puin mai mult, cu riscurile (sczut la majoritatea pacienilor) suplimentare asociate cu pneumoperitoneu (umflarea abdomenului cu gaz). Recovery may be a little quicker with laparoscopic surgery; the procedure is more expensive and resource-intensive than open surgery and generally takes a little longer, with the (low in most patients) additional risks associated with pneumoperitoneum (inflating the abdomen with gas). Sepsis pelvin avansat necesit ocazional o mai mic linia median laparotomie . Advanced pelvic sepsis occasionally requires a lower midline laparotomy . Au existat unele cazuri de auto-appendectomies, adic n timpul funcionrii pe tine. There have been some cases of auto-appendectomies, ie operating on yourself. Unul a fost efectuat de Dr Kane, n 1921, ns operaiunea a fost completat de asistenii lui. One was performed by Dr Kane in 1921, but the operation was completed by his assistants. Un alt caz este Leonid Rogozov care a trebuit s efectueze operaia pe el nsui ca el a fost chirurg numai pe o baz de la distan Arctic. [1] Another case is Leonid Rogozov who had to perform the operation on himself as he was the only surgeon on a remote Arctic base. [ 1 ]

Coninut Contents
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1 procedur 1 Procedure 2 Sarcina 2 Pregnancy 3 de recuperare 3 Recovery 4 Referine 4 References 5 Legturi externe 5 External links

[ edit ] procedur [ edit ] Procedure

n termeni generali, procedura pentru o apendicita este deschis dup cum urmeaz. In general terms, the procedure for an open appendectomy is as follows. 1. Antibioticele sunt date imediat dac exist semne de sepsis , n caz contrar o singur doz de antibiotice profilactice intravenos este dat imediat inainte de interventia chirurgicala. Antibiotics are given immediately if there are signs of sepsis , otherwise a single dose of prophylactic intravenous antibiotics is given immediately prior to surgery. 2. Anestezie general este indus, cu intubaie endotraheal i complet relaxare musculara , iar pacientul este poziionat n decubit dorsal . General anaesthesia is induced, with endotracheal intubation and full muscle relaxation , and the patient is positioned supine .

3. Abdomenul este pregtit i drapat i este examinat sub anestezie. The abdomen is prepared and draped and is examined under anesthesia. 4. Dac o mas este prezent, incizia se face peste masa, altfel, incizia se face peste punctul McBurney lui , o treime din drum de la nivelul coloanei vertebrale anterior iliace superioare (ASIS) i ombilic, acest lucru reprezint poziia de baz de anex (poziia vrful este variabil). If a mass is present, the incision is made over the mass; otherwise, the incision is made over McBurney's point , one third of the way from the anterior superior iliac spine (ASIS) and the umbilicus; this represents the position of the base of the appendix (the position of the tip is variable). 5. Straturi diferite ale peretelui abdominal sunt apoi deschise. The various layers of the abdominal wall are then opened. 6. Efortul este ntotdeauna de a pstra integritatea peretelui abdominal. The effort is always to preserve the integrity of abdominal wall. Prin urmare, oblice externe aponevrozei este slitted de-a lungul fibrei sale, i intern oblic muchiul este mprit de-a lungul lungimii sale, nu tiat. Therefore, the External Oblique Aponeurosis is slitted along its fiber, and the internal oblique muscle is split along its length, not cut. n ceea ce a condus doua unghiuri de la dreptul de a reciproc, acest lucru impiedica mai tarziu hernie incisional . As the two run at right angles to each other, this prevents later Incisional hernia . 7. La intrarea n peritoneu , apendicele este identificat, mobilizat i apoi ligated i mprit la baza acesteia. On entering the peritoneum , the appendix is identified, mobilized and then ligated and divided at its base. 8. Unii chirurgi aleg s ngroape trunchiul apendice, rsturnnd-l astfel nct s punctele n cecum . Some surgeons choose to bury the stump of the appendix by inverting it so it points into the caecum . 9. Fiecare strat al peretelui abdominal este apoi nchis la rndul su. Each layer of the abdominal wall is then closed in turn. 10. Pielea poate fi nchis cu capse sau cusaturi. The skin may be closed with staples or stitches. 11. Rana este mbrcat. The wound is dressed. 12. Pacientul va fi adus la sala de recuperare. The patient will be brought to the recovery room.

[ edit ] Sarcina [ edit ] Pregnancy

Dac apendicita dezvolt ntr-o gravid femeie, o apendicita este de obicei efectuat i nu trebuie s aduc atingere ftului . [2] risc de moarte fetal in perioada perioperatorie, dup o appendectomy de apendicita acuta timpurie este de 3% la 5%. If appendicitis develops in a pregnant woman, an appendectomy is usually performed and should not harm the fetus . [ 2 ] The risk of fetal death in the perioperative period after an appendectomy for early acute appendicitis is 3% to 5%. Riscul de moartea fatului este de 20% n apendicita perforata. [3] The risk of fetal death is 20% in perforated appendicitis. [ 3 ]

[ edit ] de redresare [ edit ] Recovery

Scar i vnti 2 zile de la operaie. Scar and bruise 2 days after operation.

Cicatricea de 10 zile dup operaie. Scar 10 days after operation. Barbat, 23-yo pacient. Male, 23-yo patient. Spitalul "Gea Manuel Gonzlez", Mexico City, mari 2011-03-opt. Hospital "Manuel Gea Gonzlez", Mexico City, Tuesday, March 8, 2011. Timpul de recuperare n urma operaiunii variaz de la persoan la persoan. Recovery time from the operation varies from person to person. Unii vor lua pn la trei sptmni nainte de a fi complet activ, pentru altii poate fi o chestiune de zile. Some will take up to three weeks before being completely active; for others it can be a matter of days. n cazul unei operaiuni de laparoscopica, pacientul va avea trei cicatrici capsate din aproximativ un centimetru in lungime, intre ombilic si linia parului pubian. In the case of a laparoscopic operation, the patient will have three stapled scars of about an inch in length, between the navel and pubic hair line. Atunci cnd o laparotomie a fost efectuat pacientul va avea o cicatrice 2-3 inch, care va fi initial puternic zdrobit. [4] When a laparotomy has been performed the patient will have a 2-3 inch scar, which will initially be heavily bruised. [ 4 ]

[ modific ] Referine [ edit ] References

1. ^ Auto-apendicectomie n Antarctica: raport de caz, BMJ 2009; 339: b4965 ^ Auto-appendectomy in the Antarctic: case report, BMJ 2009;339:b4965 2. ^ Factori de risc care se dezvolta in timpul sarcinii ^ Risk Factors That Develop During Pregnancy 3. ^ Manual Sabiston de Chirurgie 2007 ^ Sabiston Textbook of Surgery 2007 4. ^ http://www.scribd.com/doc/17692145/Surgery-2 ^ http://www.scribd.com/doc/17692145/Surgery-2

[ modific ] Legturi externe [ edit ] External links

Wikimedia Commons conine materiale multimedia legate de: apendicectomie Wikimedia Commons has media related to: Appendectomy

Video apendicectomie laparoscopice (include prezentare de caz) Laproscopic Appendectomy Video (includes case presentation)

Apendicectomie deschis, apendicectomie parte din seria ghid operativ, care explic paii n realizarea unei appendectomy deschis Open appendectomy, appendectomy Part of the operative howto series, explaining the steps in carrying out an open appendectomy Deschidei & apendicectomie laparoscopica, apendicectomie apendicectomie laparoscopica deschise i Open & Laparoscopic appendectomy, appendectomy Open and Laparoscopic appendectomy O nregistrare video a procedurii de A video of the procedure Un alt video a procedurii (necesit fie Windows Media Player i nu se vor ncrca n Firefox
1.5, sau de a folosi aceast legtur ntr-directa .. cu orice player care poate reda fisiere wmv) Another video of the procedure (Either Requires Windows Media Player and will not load in Firefox 1.5; or use this direct link with any player that can play .wmv files.)

[show] v d e tiin Sntate - Chirurgie - Chirurgie generala v d e Health

science - Surgery - General surgery

[show] v d e sistemul digestiv chirurgicale i alte proceduri / intervenii chirurgicale sistemului digestiv ( ICD-9-CM V3 42-54, ICD-10-PCS 0D ) v d e Digestive system surgical and other procedures / Digestive system surgery (

ICD-9-CM V3 42-54, ICD-10-PCS 0D )

GI superior ale tractului Upper GI tract Esofagectomie Heller miotomie Sialography Impedanta-pH-ului SGS / de monitorizare monitorizarea pH-ului esofagian esofagian esofag motilitii studiu Esophagectomy Heller myotomy Sialography SGs / Impedance-pH monitoring Esophageal pH monitoring Esophageal Esophagus motility study Gastrostomie ( gastrostomie endoscopic percutan ) gastrectomie ( Billroth I , Billroth II , Roux-en-Y ) Chirurgia bariatrica ( chirurgia by-pass gastric , trupa reglabil gastric , maneca gastrectomie , interventii chirurgicale Vertical gastroplasty banded ) Gastroenterostomy Hill repararea fundoplication Nissen Stomac Gastropexy Pyloromyotomy Gastrostomy ( Percutaneous Stomach endoscopic gastrostomy ) Gastrectomy ( Billroth I , Billroth II , Roux-en-Y ) Bariatric surgery ( Gastric bypass surgery , Adjustable gastric band , Sleeve gastrectomy , Vertical banded gastroplasty surgery ) Gastroenterostomy Hill repair Nissen fundoplication Gastropexy Pyloromyotomy Imagistica Endoscopie : Esophagogastroduodenoscopy Endoscopy :

Esophagogastroduodenoscopy medicala Medical Serie gastro-intestinal superior nghii de bariu Upper imaging gastrointestinal series Barium swallow IntestinuluiChirurgia bariatrica ( comuta duodenale , by-pass Jejunoileal ) subtire Jejunostomy ileostomie parial a se ileal by-pass intervenii Small chirurgicale Bariatric surgery ( Duodenal switch , Jejunoileal bowel bypass ) Jejunostomy Ileostomy Partial ileal bypass surgery Mare Colectomy colostomie Appendicectomy Hartmann intestinului funcionarea polipectomie Colonic Colectomy Colostomy Large Appendicectomy Hartmann's operation Colonic polypectomy bowel Rect Rectum Rezecie anterioar de Jos rezecie abdominoperineal Lower anterior resection Abdominoperineal resection

Ligaturarea banda de cauciuc Sphincterotomia Anal Mai mici Sphincterotomia Lateral interne dearterialization Transanal Anal canal ale hemoroidale manometry anorectale Rubber band ligation Anal Anal canal tractului sphincterotomy Lateral internal sphincterotomy Transanal gastrohemorrhoidal dearterialization Anorectal manometry intestinal Lower Endoscopie : Colonoscopia Proctoscopy Sigmoidoscopia GI tract Enteroscopy anoscopy capsulei endoscopie Endoscopy : Colonoscopy Proctoscopy Sigmoidoscopy Enteroscopy Anoscopy Capsule endoscopy Imagistica medicala Ecografie transrectala abdominala ecografie Enteroclysis Medical intestinului subtire urmeze-prin intermediul serie de Jos gastroimaging intestinale Colonoscopia virtuala proctogram defecare dublucontrast clisma bariu Transrectal ultrasonography Abdominal ultrasonography Enteroclysis Small bowel follow-through Lower gastrointestinal series Virtual colonoscopy Defecating proctogram Double-contrast barium enema Taburet Fecale pH-ului de testare scaun de ncercare guaiac ncercare teste Stool fecalii grsime Fecal pH test Stool guaiac test Fecal fat test tests Hepatectomy transplantul de ficat sprijin artificiale hepatice extracorporal ( dializ hepatic , dispozitive Bioartificial ficat ) Biopsia Ficat Liver hepatica Hepatectomy Liver transplantation Artificial extracorporeal liver support ( Liver dialysis , Bioartificial liver devices ) Liver biopsy

Cholecystostomy ERCP colecistectomiilor Hepatoportoenterostomy Vezicii Cholecystostomy ERCP Cholecystectomy Hepatoportoenterostomy biliare , ductului biliar Imagistic medical : cholangiography ( PTC , IV , MRCP ) GallbladderCholecystography Cholescintigraphy Medical imaging : Cholangiography ( , bile duct PTC , IV , MRCP ) Cholecystography Cholescintigraphy Pancreas Pancreas Pancreatectomy Pancreaticoduodenectomy transplant pancreatic Puestow procedura Frey de procedur Pancreatectomy Pancreaticoduodenectomy Pancreas transplantation Puestow procedure Frey's procedure

Laparoscopia diagnostic peritoneal prin lavaj Paracenteza injecie Peritoneu intraperitoneal dializa peritoneala Omentopexy Laparoscopy Diagnostic Peritoneumperitoneal lavage Paracentesis Intraperitoneal injection Peritoneal dialysis Omentopexy Hernie Hernia Hernie de reparatii : reparatii hernie inghinala ( operaie Macewen lui ) femural hernie de reparaii Hernia repair : Inguinal hernia repair ( Macewen's operation ) Femoral hernia repair

M : DIG M : DIG

ANAT ( T , g , p ) / noco / Cong / tumr , proc , de droguri ( fiz / devp / enzy anat( sysi / epon noco / A2A / 2B / 3 / 4 / 5 / t , g , p )/ phys / cong / tumr , sysi / 6 / 7 / 14 / 16 ), blte devp / enzy epon proc , drug ( A2A / 2B / 3 / 4 / 5 / 6 / 7 / 14 / 16 ), blte

[show] v d e Chirurgie : proceduri chirurgicale (inclusiv Ectomy , stomy , i otomy ) v d e Surgery : surgical procedures (including Ectomy , stomy , and

otomy )

Genital Genital : Vasectomia penectomie orhidectomie prostatectomie Posthectomy Gonadectomy : Vasectomy Penectomy Orchidectomy Prostatectomy Posthectomy Gonadectomy MusculoBursectomy amputare ( Hemicorporectomy , Hemipelvectomy ) scheletice Bursectomy amputation ( Hemicorporectomy , Hemipelvectomy ) Musculoskeletal Ale sistemului CNS ( craniectomy Decompressive , Hemispherectomy , temporale nervos Nervous Anterior cns ( Decompressive craniectomy , Hemispherectomy ,

system

Anterior temporal simpatectomie toracic , neurectomia ) ureche ( Stapedectomy , Mastoidectomy ) ochi ( keratectomy photorefractive , Trabeculectomy , iridectomie , vitrectomia ) thoracic sympathectomy , Neurectomy ) ear ( Stapedectomy , Mastoidectomy ) eye ( Photorefractive keratectomy , Trabeculectomy , Iridectomy , Vitrectomy )

Gastrointestinal Gastrointestinal Respirator Respiratory Endocrin Endocrine Renal Renal Limfatic Lymphatic Sn Breast Osoase / articulare Bone / joint Degrupate Ungrouped GastrointestinalGastrostomie ( endoscopica percutanata Gastrostomy ( Percutaneous Gastrointestinalendoscopic Urogenital Urogenital Nefrostomie Ureterostomy Cystostomy ( suprapubian cystostomy ) urostomie Nephrostomy Ureterostomy Cystostomy ( Suprapubic cystostomy ) Urostomy Rhinectomy laringectomie Pneumonectomy Rhinectomy Laryngectomy Pneumonectomy Hipofizectomie tiroidectomie paratiroidectomia Adrenalectomy Pinealectomy Hypophysectomy Thyroidectomy Parathyroidectomy Adrenalectomy Pinealectomy Nefrectomie cystectomy Nephrectomy Cystectomy Amigdalectomie adenoidectomy timectomie Splenectomia limfadenectomie Tonsillectomy Adenoidectomy Thymectomy Splenectomy Lymphadenectomy Lumpectomy Mastectomia Lumpectomy Mastectomy Coccygectomy Ostectomy ( ostectomy capului femural ) Astragalectomy Discectomia Synovectomy Coccygectomy Ostectomy ( Femoral head ostectomy ) Astragalectomy Discectomy Synovectomy

Ale sistemului Ventriculostomy ochi ( Dacryocystorhinostomy ) Ventriculostomy eye nervos Nervous ( Dacryocystorhinostomy ) system Urogenital Amniotomia Clitoridotomy Hysterotomy Hymenotomy

Urogenital

Epiziotomia Meatotomy Nephrotomy Amniotomy Clitoridotomy Hysterotomy Hymenotomy Episiotomy Meatotomy Nephrotomy

Ale sistemului CNS ( craniotomy , Pallidotomy , Thalamotomy , lobotomie , Bilaterale nervos Nervous cns ( Craniotomy , Pallidotomy , Thalamotomy , Lobotomy , Bilateral system keratotomy ) keratotomy ) MusculoMiotomie tenotomie Fasciotomy Escharotomy Osteotomia scheletice Arthrotomy Myotomy Tenotomy Fasciotomy Escharotomy MusculoskeletalOsteotomy Arthrotomy Miotomie ( miotomie Heller , Pyloromyotomy ) Sphincterotomia Anal Gastrointestinal lateral interne Sphincterotomia Myotomy ( Heller myotomy , Gastrointestinal Pyloromyotomy ) Anal sphincterotomy Lateral internal sphincterotomy Respirator Respiratory Sinusotomy Cricothyrotomy Bronchotomy toracotomie Thyrotomy traheotomie Sinusotomy Cricothyrotomy Bronchotomy Thoracotomy Thyrotomy Tracheotomy

Cardiovascular Cardiotomy flebotomie Cardiotomy Phlebotomy Cardiovascular Degrupate Laparotomie Laparotomy Ungrouped Adus de la " http://en.wikipedia.org/wiki/Appendectomy " Retrieved from " http://en.wikipedia.org/wiki/Appendectomy " View page ratings Rate this page What's this? Trustworthy Objective Complete Well-written I am highly knowledgeable about this topic (optional) I have a relevant college/university degree It is part of my profession It is a deep personal passion The source of my knowledge is not listed here I would like to help improve Wikipedia, send me an e-mail (optional) We will send you a confirmation e-mail. We will not share your address with anyone. (Privacy policy) Submit ratings

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