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Abstract: A 24-year-old male patient presented with severe abdominal pain. After consultation, palpation, and routine blood tests, he was found to have acute appendicitis, which required radical surgery, such as laparoscopic appendectomy for treatment, with postoperative use of injectable ceftriaxone sodium to prevent infection. After 5 days of treatment, his body recovered to normal, and the results of his tests were relatively normal when he was retested 1 month after discharge.
[Basic information] Male, 24 years old
Disease Type】Acute appendicitis
Hospital】The First Affiliated Hospital of Xi’an Jiaotong University
Date of Consultation】March 2022
Treatment plan】Surgical treatment (laparoscopic appendectomy) + intravenous injection (gentamicin sulfate injection)
Treatment period】5 days of hospitalization and 1 month after discharge for review
Treatment effect】The physical discomfort gradually disappeared, and the indexes of each examination returned to normal.
I. Initial consultation
A 24-year-old patient suddenly came to our hospital with severe abdominal pain, complaining of pain around the navel in the morning and a little fever. However, in the afternoon, the pain around the navel stopped, but the pain in the right lower abdomen started to persist again. I found by palpation that the abdominal muscles were tight and there was pressure pain in the right lower abdomen at the location of the outer third of the line between the navel and the right anterior superior iliac spine, which is the McDonald’s point, and considered the presence of acute appendicitis. The patient’s blood count was found to be elevated, so he was considered to have appendiceal infection and inflammation, and was admitted to our general surgery department as “acute appendicitis” for treatment.
II. Treatment process
After communicating with the patient and his family and explaining the necessity of surgery, the patient was treated with laparoscopic appendectomy under general anesthesia, and the area to be incised was prepared and disinfected before surgery. The operation went relatively smoothly and the patient returned safely to the ward after awakening from anesthesia. Postoperatively, gentamicin sulfate injection was taken to inhibit the occurrence of infection in the surgical wound, and the patient was instructed to pay attention to the protection of the wound, and after the wound recovered, the patient was discharged from the hospital.
III. Treatment effect
The patient’s symptoms improved after 5 days of hospitalization, and the symptoms of vague pain in the right lower abdomen, pressure pain at the point of McDonald’s, and rebound pain, fever, and abdominal muscle tension were relieved without other postoperative complications. The routine blood test revealed that the white blood cell count returned to normal, and the operation was more successful. The patient met the discharge indications, and one month after discharge, the patient returned to the hospital for a review with normal results and good health.
IV. Precautions
After the patient received laparoscopic appendectomy treatment, the somatic symptoms disappeared and the examination results showed normal, which made me feel relieved. At the time of discharge, I reminded the patient that he should pay attention to avoid overeating in daily life and reduce the intake of indigestible and greasy food, otherwise it would increase the digestive burden and be detrimental to the body recovery. In life, you can eat more easily digestible and nutritious food, such as egg custard, lean meat porridge, etc. You should pay attention to appropriate jogging, walking after meals and other exercises, all of which can help strengthen your body and reduce the probability of disease. If symptoms such as abdominal pain and fever appear again after discharge from the hospital, it is recommended to receive timely treatment at the hospital.
V. Personal insight
Acute appendicitis is usually caused by the invasion of the appendix by pathogenic microorganisms. At the onset of the disease, inflammation in the appendix can stimulate the abdomen and cause severe pain, and surgery is needed to remove the infected appendix in order to effectively improve the symptoms, which is treated by laparoscopic appendectomy. If the patient is not treated in time, the inflammation will continue to worsen, leading to local pus and acute suppurative appendicitis.