d. Diagnosis.
(1) The patient can usually point to the location of pain. If the patient is
asked to cough, the main point of pain will be one-third the distance from the anterior
iliac crest to the umbilicus.
(2) Since perforation rarely occurs during the first eight hours of signs and
symptoms, it is generally safe to observe for diagnosis during this time.
(3) There is a moderate increase in the number of leukocytes in the blood
(leukocytosis--10 to 20 thousand) with an increase in white blood cells, specifically the
neutrophils.
e. Treatment.
(1)
Before surgical facilities are available, have the patient follow this
procedure:
(a) Bed rest in the semi-Fowler's position.
(b) Nothing by mouth. Give intravenous fluids as necessary, and keep
an accurate record of the patient's fluid intake and output.
(c)
Ice bag to the abdomen. DO NOT apply heat to the appendix
site.
(d)
Prophylactic antibiotics or analgesics may be given at the discretion
of the surgeon.
(e)
DO NOT give laxatives or enemas.
(2)
When surgical facilities are available, the appendix should be removed.
3-14. DIVERTICULOSIS
a. Definition. The disease diverticulum of the colon is a protruding of the
intestinal mucosa to form a sac. Diverticulosis is the condition when these protruding
sacs are not inflamed and cause no symptoms. The condition becomes diverticulitis
when feces become trapped in the sacs causing the diverticula to become inflamed and
painful.
MD0581
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