tailieunhanh - Ebook Imaging for surgical disease: Part 2

(BQ) Part 2 book "Imaging for surgical disease" presents the following contents: Appendicitis, renal cyst, renal cell carcinoma, wilms tumor, horseshoe kidney, splenic artery aneurysm, splenic cyst, splenic infarction, traumatic brain injury, subdural hematoma,. | Appendix Appendicitis Overview Most common in teenage years and patients in their 20s Rate of appendectomy for appendicitis is 10 per 10 000 patients per year Usually due to lymphoid hyperplasia or fecalith causing luminal obstruction Signs and Symptoms Anorexia 90 Abdominal pain Periumbilical migrating to RLQ Nausea and vomiting 70 Low-grade fever Physical Examination Findings Point tenderness typically over McBurney point Psoas sign Pain with extension of right thigh while in left lateral decubitus position Obturator sign Pain with passive rotation of flexed right hip Rovsing s sign Pain in RLQ while palpating LLQ Rectal examination may reveal a pelvic mass or abscess Laboratory Findings Patients can have a normal WBC count but usually mild leukocytosis in the range of 10 000 to 18 000 mm3 Urinalysis may be positive with pyuria hematuria and albuminuria Chapter 9 Appendix 245 Treatment IV fluid resuscitation and peri-operative antibiotics Laparoscopic or open appendectomy For perforated appendix may undergo appendectomy if there is no inflammatory phlegmon. If there is an inflammatory phlegmon conservative management with IV antibiotic with percutaneous drainage of any associated abscess KEY POINT The risk of a ruptured appendicitis increases at 24 hours from the initial presentation of signs and symptoms RADIOLOGY Appendicitis Plain film findings Usually normal Adynamic ileus may be seen Sometimes a calcified appendicolith in the right lower quadrant is seen US findings Blind-ending tubular structure that is noncompressible outer wall to outer wall diameter greater than 6 mm If identified an appendicolith casts a clean posterior acoustic shadow Tenderness over appendix False negative can result from retrocecal appendicitis gangrenous or perforated appendicitis gas-filled appendix and massively enlarged appendix CT findings Fig. Appendix measuring greater than 6 mm in diameter failure of appendix to fill with oral contrast or air up to its tip Adjacent cecal

• Y khoa - Dược
• Imaging for surgical disease
• Renal cyst
• Renal cell carcinoma
• Wilms tumor
• Horseshoe kidney
• Splenic artery aneurysm
• Splenic cyst