Lec 7 acute appendicitis and cholescystitis

1. Acute Appendicitis
MBChB: Mohammed N Abed
Institute of Medical Technology
Official Email:abedm@imt.edu.iq
College/
Institute
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MBChB: Mohammed N Abed
Official Email: abedm@imt.edu.iq
Middle Technical University - Iraq ‫الوسـطى‬ ‫التقنية‬ ‫الجامعة‬-‫العراق‬

2. Acute Appendicitis
Appendicitis is inflammation of the appendix.
It may be acute or chronic.
Appendicitis occurs most often between the ages
of 10 and 30. It is more common in men than in
women. Untreated appendicitis can be fatal.
College/
Institute
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MBChB: Mohammed N Abed
Official Email: abedm@imt.edu.iq
Middle Technical University - Iraq ‫الوسـطى‬ ‫التقنية‬ ‫الجامعة‬-‫العراق‬

3. Causes
Obstruction is often caused by an
accumulation of fecal matter. It can also be
caused by:
• enlarged lymphoid follicles
• worms
• trauma
• tumors
College/
Institute
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MBChB: Mohammed N Abed
Official Email: abedm@imt.edu.iq
Middle Technical University - Iraq ‫الوسـطى‬ ‫التقنية‬ ‫الجامعة‬-‫العراق‬

4. When the appendix is obstructed, bacteria can
multiply inside the organ. This leads to the
formation of pus. The increased pressure can
be painful. It can also compress local blood
vessels. A lack of blood flow to the appendix
may cause gangrene.
College/
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MBChB: Mohammed N Abed
Official Email: abedm@imt.edu.iq
Middle Technical University - Iraq ‫الوسـطى‬ ‫التقنية‬ ‫الجامعة‬-‫العراق‬

5. If the appendix ruptures, fecal matter can fill
the abdomen.
This is a medical emergency.
If the infected appendix leaks instead of
ruptures, it can form an abscess. This confines
the infection to a small area. However, an
abscess can still be dangerous.
College/
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MBChB: Mohammed N Abed
Official Email: abedm@imt.edu.iq
Middle Technical University - Iraq ‫الوسـطى‬ ‫التقنية‬ ‫الجامعة‬-‫العراق‬

6. Symptoms
1. lower right side abdominal pain
2. loss of appetite
3. nausea
4. vomiting
5. diarrhea
6. constipation
7. inability to pass gas
8. abdominal swelling
9. low grade fever
10. a sense you might feel better after passing stool
College/
Institute
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MBChB: Mohammed N Abed
Official Email: abedm@imt.edu.iq
Middle Technical University - Iraq ‫الوسـطى‬ ‫التقنية‬ ‫الجامعة‬-‫العراق‬

7. Diagnosis
A physical exam for appendicitis looks for
tenderness in the lower right quadrant of your
abdomen.
In rare cases, appendicitis may get better
without surgery. Treatment might involve only
antibiotics and a liquid diet.
College/
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MBChB: Mohammed N Abed
Official Email: abedm@imt.edu.iq
Middle Technical University - Iraq ‫الوسـطى‬ ‫التقنية‬ ‫الجامعة‬-‫العراق‬

8. In most cases, however, surgery will be necessary If you have an
abscess that has not ruptured, you will first be treated with
antibiotics.
Your abscess will then be drained with a tube placed through your
skin. Surgery will remove your appendix after your infection has
been treated.
If you have a ruptured abscess or appendix, surgery may be needed
right away. Surgery to remove the appendix is called an
appendectomy.
College/
Institute
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MBChB: Mohammed N Abed
Official Email: abedm@imt.edu.iq
Middle Technical University - Iraq ‫الوسـطى‬ ‫التقنية‬ ‫الجامعة‬-‫العراق‬

9. Acute cholecystitis
Acute cholecystitis is sudden swelling and
irritation of the gallbladder.
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Institute
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MBChB: Mohammed N Abed
Official Email: abedm@imt.edu.iq
Middle Technical University - Iraq ‫الوسـطى‬ ‫التقنية‬ ‫الجامعة‬-‫العراق‬

10. Causes
• Gallstone blocks the cystic duct, the tube through
which bile travels into and out of the gallbladder. When a
stone blocks this duct, bile causing irritation and pressure
in the gallbladder. This can lead to swelling and infection.
• Serious illnesses, such as HIV or diabetes
• Tumors of the gallbladder (rare)
• Some people are more at risk for gallstones. Risk
factors include:
• 5 Fs ; female, fatty, fertile, forty-fifty & fair
College/
Institute
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MBChB: Mohammed N Abed
Official Email: abedm@imt.edu.iq
Middle Technical University - Iraq ‫الوسـطى‬ ‫التقنية‬ ‫الجامعة‬-‫العراق‬

11. Symptoms
1. upper right abdomen :
2. Nausea or vomiting.
3. Tenderness in the right abdomen.
4. Fever.
5. Pain that gets worse during a deep breath.
6. Pain for more than 6 hours, particularly after meals.
7. Yellowing of skin and whites of the eyes (jaundice)
8. Clay-colored stools
College/
Institute
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MBChB: Mohammed N Abed
Official Email: abedm@imt.edu.iq
Middle Technical University - Iraq ‫الوسـطى‬ ‫التقنية‬ ‫الجامعة‬-‫العراق‬

12. Diagnosis
• Bilirubin level
• Complete blood count (CBC)
• Liver function tests
• Imaging tests can show gallstones or inflammation.
as may have one of these tests:
• Abdominal ultrasound
• Abdominal CT scan
• Abdominal x-ray
• Oral cholecystogram
• Gallbladder scan
College/
Institute
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MBChB: Mohammed N Abed
Official Email: abedm@imt.edu.iq
Middle Technical University - Iraq ‫الوسـطى‬ ‫التقنية‬ ‫الجامعة‬-‫العراق‬

13. Treatment
If have severe pain,to seek medical attention right away.
In the emergency room, to give fluids through a vein. also
may be given antibiotics to fight infection.
Cholecystitis may clear up on its own. However, if have
gallstones, will probably need surgery to remove
gallbladder.
Nonsurgical treatment includes:
• Antibiotics to fight infection
• Low-fat diet
• Pain medicines
College/
Institute
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MBChB: Mohammed N Abed
Official Email: abedm@imt.edu.iq
Middle Technical University - Iraq ‫الوسـطى‬ ‫التقنية‬ ‫الجامعة‬-‫العراق‬

14. Complications
Untreated, cholecystitis may lead to any of the following
health problems:
• Empyema (pus in the gallbladder)
• Gangrene
• Injury to the bile ducts draining the liver (may occur
after gallbladder surgery)
• Pancreatitis
• Perforation
• Peritonitis (inflammation of the lining of the
abdomen)
College/
Institute
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MBChB: Mohammed N Abed
Official Email: abedm@imt.edu.iq
Middle Technical University - Iraq ‫الوسـطى‬ ‫التقنية‬ ‫الجامعة‬-‫العراق‬