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Abstract: The patient in this case is a young woman who presented with right lower abdominal pain with nausea and abdominal distension 2 years ago, which improved after treatment with outside hospitals, but the above discomfort still recurred intermittently, so she came to our hospital and was diagnosed with chronic appendicitis after physical examination and laboratory tests, and was treated with surgical resection and discharged 5 days after surgery.
Basic information】Female, 30 years old
Disease Type】Chronic appendicitis
Hospital】The First Hospital of China Medical University
Date of consultation】August 2020
Treatment plan】Surgical treatment (laparoscopic appendectomy) + medication (injectable sodium naproxen, injectable sodium hepaticoside, vitamin C injection, vitamin B6 injection)
Treatment period】5 days in hospital
Treatment effect] Abdominal pain and distension disappeared and chronic appendicitis was cured
I. Initial consultation
The patient, female, 30 years old, had pain and discomfort in the right lower abdomen with occasional nausea and abdominal distension without any obvious cause 2 years ago, without fever, and was considered to have appendicitis. On outpatient examination, there was pressure pain in the right lower part of the body without rebound pain; routine blood tests showed mildly elevated leukocyte count; X-ray colonography showed deformation and narrowing of the appendiceal lumen, and the preliminary diagnosis was chronic appendicitis.
II. Treatment process
After the patient was admitted to the hospital, the abdominal CT examination was completed, suggesting a high-density foci in the appendix, and considering the possible presence of fecal stones in the appendix. During the operation, the appendix was removed, pathological diagnosis was performed, and the visible fluid in the pelvis and right side of the abdomen was aspirated without intraoperative accidents. Postoperative examination of the appendix, which contained several fecal stones at its end, confirmed an acute attack of chronic appendicitis. It was confirmed to be an acute attack of chronic appendicitis. It was consistent with the preoperative CT findings. After the patient returned to the ward safely, he was given injectable sodium naproxen to relieve fever and analgesia, injectable sodium hesperidin to relieve swelling of the surgical incision, and vitamin C injection and vitamin B6 injection as adjuvant therapy.
III. Treatment results
The patient’s surgery went smoothly, with less intraoperative bleeding. On the first day after surgery, there was no obvious abdominal pain and distension, and the incision was painful but not strong, and the anus was exhausted. Four days after the operation, the patient resumed normal defecation and urination, and the abdominal discomfort basically disappeared, and the examination showed that the incision was healing well without redness and exudation, and the pathology was reported as chronic appendicitis, so the patient was discharged from the hospital to recuperate at home.
IV. Notes
The patient was very happy to learn that the pathological results were normal. I was very pleased to think that the patient was sweating profusely due to abdominal pain when he was admitted to the hospital. At the same time, the patient’s hand was advised to go to the outpatient clinic regularly to change the auxiliary materials of the surgical incision to avoid infection of the incision and prolong the recovery time; during the recuperation period at home, although strenuous exercise is not recommended, it is possible to take a walk outdoors and do aerobics, and appropriate exercise is also beneficial to the healing of the wound; in addition, before the surgical incision is completely healed, it is not recommended to eat foods that are too stimulating, such as chili, onion, ginger, etc., and not to In addition, before the surgical incision is completely healed, it is not recommended to eat too strong stimulating food, such as chili, onion, ginger, etc., and not to scratch the incision with hands, so as not to affect the healing of the surgical incision and affect the beauty.
V. Personal insight
Most patients with chronic appendicitis are the same as the patient in this article. After conservative treatment of acute appendicitis, it causes deformation of the appendiceal cavity, resulting in retention of fecal stones in the cavity, causing recurrent abdominal pain, abdominal distension and other uncomfortable symptoms, which affects the quality of life. In this case, we should promptly seek surgical treatment to remove the appendix and reasonably apply antibiotics, which can mostly improve. On the contrary, if treatment is delayed, it may cause abdominal abscesses and even serious complications such as ruptured appendix with intestinal fistula. The good thing is that this patient’s condition is not serious, and after surgery, he was cured in about half a month.