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Abstract: A 68-year-old aunt Zhao came to our hospital with sudden and persistent abdominal pain. After physical examination, she was found to have elevated body temperature, pressure pain and rebound pain in the right lower abdomen at the Maier’s point, a mass in the right lower abdomen by abdominal ultrasound, elevated white blood cell count by routine blood count, and acute gangrenous appendicitis by abdominal CT, so she was treated by emergency laparoscopic appendectomy and postoperative prophylaxis of infection with injectable penicillin sodium. After 5 days of hospitalization, her body basically recovered, and the results of the review were normal 1 month after discharge.
Basic information】 Female, 68 years old
Disease Type】Appendicitis
Hospital】The First Affiliated Hospital of Xi’an Jiaotong University
Date of consultation】March 2022
Treatment plan】Surgical treatment (laparoscopic appendectomy) + medication (penicillin sodium for injection)
Treatment period】5 days of hospitalization, 1 month after discharge for review
Treatment effect] The physical discomfort gradually disappeared, and the results of routine blood, abdominal ultrasound and abdominal CT examination were normal.
I. Initial consultation
She complained of persistent dull pain in her right lower abdomen and some fever, but no other physical abnormalities. I also found a swelling in the right lower abdomen through abdominal ultrasound and elevated leukocyte values through routine blood tests, and considered the presence of acute appendicitis, and admitted to our hospital with appendicitis as an outpatient. Later, CT examination of the abdomen revealed that there was fluid in the appendix cavity and fluid around it, the appendix was not clearly demarcated from the surrounding area, and there was a mass around the appendix, which might be abscess formation.
II. Treatment history
After the diagnosis of acute gangrenous appendicitis, I communicated with the patient and the patient’s family and informed them of the necessity of surgery. The operation was successfully completed, and sodium penicillin for injection was given to prevent surgical wound infection after the operation. After the operation, the acute gangrenous appendicitis was further clarified through pathological tissue biopsy of the removed appendix.
III. Treatment effect
After 5 days of hospitalization, Auntie Zhao’s surgical incision gradually healed, her complaints of pain in the right lower abdomen were relieved, her fever disappeared, and her body temperature was found to be normal after physical examination, and I found that Auntie Zhao’s pressure pain and rebound pain at the Mai’s point disappeared through palpation. Auntie Zhao was discharged from the hospital, and one month after her discharge, it was confirmed that she was in good health and all indicators were normal.
IV. Notes
At the same time, I told the patient that she needed to pay attention to diet control after discharge, with light, easily digestible and nutritious food, such as lean meat porridge and pumpkin porridge, etc. She could also eat foods rich in dietary fiber, such as apples and spinach, to increase intestinal peristalsis and prevent constipation, but avoid spicy and stimulating foods. Avoid spicy and stimulating foods. Regular aerobic exercise, such as brisk walking, square dancing, etc., can promote metabolism and help restore energy. In general, you should maintain an optimistic and positive attitude, and if any discomfort occurs after discharge, it is recommended to return to the hospital at any time.
V. Personal insight
Auntie Zhao came to our hospital in time after she developed acute gangrenous appendicitis. Since the inflammation has not yet spread to the surrounding organs, the scope of infection is not yet large, and the appendix will be completely removed through laparoscopic appendectomy, Auntie Zhao’s physical condition will improve, but if Auntie Zhao does not seek medical treatment in time, resulting in the spread of inflammation to the intestines and other parts, then it will cause more physical discomfort and even make the operation more difficult, so For this disease, the more timely the treatment, the better the prognosis will be.