Guan Zheng began to teach Xu Jiuyan to popularize science, saying: "Appendicectomy is used for the treatment of acute appendicitis, suppurative appendicitis, gangrenous appendicitis, etc. In general, the operation is easy, but sometimes it is difficult, such as ectopic appendix. This is a very common acute abdomen. Most people are born with the appendix descending into the right iliac fossa. If embryonic development is abnormal, the appendix can stay in any part of the abdominal cavity. When acute inflammation occurs in the abnormal position of the appendix, it is diagnosed There are certain difficulties in the diagnosis. The most common ectopic appendixes in clinical practice are pelvic, inferior and left side of the liver. Ectopic acute appendicitis is not easy to diagnose, and is often misdiagnosed as an inflammatory disease of the organ at the ectopic site, for example, liver Acute appendicitis in the lower or upper position is often misdiagnosed as acute cholecystitis. Acute appendicitis in the deep part of the pelvic cavity in women will be misdiagnosed as an inflammatory disease of the pelvic organs. When it is located in the left lower abdomen, unless the midgut is known to have nonrotational deformity or accompanied by It is generally difficult to diagnose dextrocardia before surgery. Therefore, as a doctor, patients with pain and fixed tenderness located outside the right lower abdomen must carefully ask for the medical history, perform a comprehensive physical examination, and think about the possibility of ectopic appendicitis.
The small intestine is located on the right, the colon is located on the left cecum, and the appendix is ectopic in the left lower abdomen. In addition, the rotation is not complete, which means that the cecum and appendix are located in a certain part of the rotation, such as the upper left abdomen or under the liver. The latter is also called the high appendix. The incomplete ascending colon fixation is caused by the variable position of the appendix due to the blind ascending colon fixation. At the same time, reverse translocation is extremely rare when the midgut rotates clockwise so that the small intestine is all on the left, the ascending colon is on the right, and in rare cases the cecum and appendix are in the middle. Therefore, it must not be considered that appendectomy is a minor operation. Attention must be paid to improve the treatment effect and avoid or reduce the occurrence of postoperative complications and sequelae.
The appendix, also known as the lumbric process, is a slender and curved blind tube located at the lower right of the abdomen, between the cecum and the ileum. Its root is connected to the posterior medial wall of the cecum. The appendix can be extended to any position of the abdominal cavity due to the influence of the mesangium. The appendix is located at the lower right of the abdomen, between the cecum and the ileum. It is a slender and curved blind tube with atresia at the distal end.
The appendix is rich in lymphoid tissue, which participates in the body's immune function, which should be attributed to the peripheral immune organs. It is responsible for the body's cellular immunity and humoral immunity. The latest research results confirm that the appendix also has secretory cells that can secrete a variety of substances and various digestive enzymes, as well as hormones that promote peristalsis and growth-related hormones.
After the fetus is born, a small amount of lymphatic tissue begins to accumulate in the appendix. In fact, the appendix is essentially a lymphatic organ. The return direction of lymphatic fluid is consistent with the return of venous blood, reaching the ileocolonic lymph nodes. The lymphatic tissue of the appendix begins to appear after birth, peaks at the age of twelve to twenty, then gradually decreases and disappears after the age of fifty-five. Therefore, the removal of the appendix in adults does not damage the body's immune function. But for children, it will affect the immune system to some extent.
In the early stages of human development, the appendix, as a lymphatic organ, contributes to the maturation of B lymphocytes. B lymphocytes are white blood cells and produce antibodies called immunoglobulins. Have you heard of this? "
Xu Jiuyan nodded and said, "I know this. Then after adulthood, can the appendix be cut?"
Seki Zheng went on to say: "It is generally believed that the appendix has developed lymphoid tissues in children and youth, which can transfer immunologically active lymphocytes. Therefore, the appendix can be called one of the immune organs. After adults, this immune function has been The whole body lymph nodes and spleen are replaced. In addition, the appendix mucosa has a secretory function, and the appendix wall also has a peristaltic function. The white blood cells can affect various antigens or foreign bodies in the gastrointestinal tract, so that the appendix may inhibit the destruction of blood and lymph. The humoral antibody response promotes local immune function. The appendix is like a small collection of Peyer’s lymph nodes in other parts of the gastrointestinal tract, which absorbs antigens from the contents of the intestine and reacts to these contents. This local immune system is in Biology and the control of food, medicine, microorganisms and viral antigens have played a vital role.
Therefore, the appendix can help suppress potentially damaging humoral antibody responses, and at the same time provide local immunity. The appendix absorbs and responds to antigens in the intestine. This local immune system responds to physiological immune responses and food, Drugs, bacteria or viral antigens play an important role in the control. If the balance of bacteria in the intestine is imbalanced, it may lead to ulcerative colitis and Crohn's disease, and food poisoning is prone to occur, so do not remove the appendix easily. In view of these physiological functions of the appendix, doctors urge people to treat the appendix well and not to remove it easily, even for adults. "
"It turned out to be like this!" Xu Jiuyan pouted, and said, "Well, what are you doing for that person? Now the doctor-patient relationship can't be dealt with by doctors, why are you a policeman intervening?"
Guan Zheng laughed and said, “You don’t understand this. Who doesn’t want to talk to people who have a common language? I do this to let them know that we all have medical experience and that we can understand each other. There is more tacit understanding, which is very helpful for our inquiry."
Xu Jiuyan looked at Guanzheng disgustingly, and said, "Why are you so mindful? You are like a wolf."
Guan Zheng pulled Xu Jiuyan in his arms and said, "Then you have also entered the arms of the wolf."
Xu Jiuyan raised her mouth slightly and said, "A satyr!"
Guan Zheng smiled and said, "Are you afraid?"
"I'm married, what else is there to be afraid of?" Xu Jiuyan said readily.
Guan Zheng and Xu Jiuyan waited shortly before the doctor came out.
Guan Zheng walked over and asked, "Is this patient with appendicitis okay?"
The doctor nodded and said, "It's okay. The operation was successful. You can see him in a while. Fasting on the day of the operation is today, liquid on the first day after the operation, and soft food on the second day. Under normal circumstances, the first General food can be taken for three or four days. And strong irritating soapy water**, so as not to increase intestinal peristalsis, and cause the appendix stump ligature to fall off or suture the wound to split. You can get up and move around 24 hours after surgery to promote intestinal peristalsis. Recover to prevent intestinal adhesions. Patients should keep warm after surgery to prevent falling pneumonia."
Guan Zheng also took a sigh of relief and said, "Uh, that, we are not his family members."
Xu Jiuyan took out her credentials and said: "We are the police. Doctor, I have a few more questions to ask you, do you have time?" (End of this chapter)