Complications of acute appendicitis refer to adverse outcomes resulting from delayed diagnosis, inadequate treatment, or disease progression.

Complications of acute appendicitis refer to adverse outcomes resulting from delayed diagnosis, inadequate treatment, or disease progression. These complications can lead to significant morbidity and require urgent medical intervention.

Major Complications of Acute Appendicitis:
Perforation

Rupture of the inflamed appendix, leading to leakage of infected contents into the peritoneal cavity.
Increases the risk of peritonitis and sepsis.
Peritonitis

Diffuse inflammation of the peritoneal cavity due to appendix perforation.
Symptoms include severe abdominal pain, fever, tachycardia, and rigid abdomen.
Appendiceal Abscess

Localized collection of pus around the appendix, often forming after perforation.
May require drainage and prolonged antibiotic therapy.
Appendiceal Phlegmon

A localized inflammatory mass involving the appendix, surrounding tissues, and omentum.
Managed with antibiotics initially, followed by interval appendectomy.
Sepsis

Systemic infection due to bacterial spread from perforation or abscess.
Presents with fever, hypotension, tachycardia, and multi-organ dysfunction.
Bowel Obstruction

Can result from adhesions post-appendectomy or from an appendiceal mass.
Symptoms include abdominal distension, vomiting, and constipation.
Pylephlebitis (Septic Thrombophlebitis of the Portal Vein)
A rare but serious complication where infection spreads to the portal venous system.
Leads to liver abscesses and systemic infection.

1. Complications of the
acute appendicitis
The department of the surgical diseases and transplantology of the
Urganch branch
of the Tashkent medical academy

2. Complications of the acute appendicitis
(before the operation)
Appendicular infiltrate
Appendicular abscess
Peritonitis
Pilephlebitis
Flegmona of the extraperitoneal space
Sepsis

3. Complications of the acute appendicitis
(early postoperative)
Continuously peritonitis
Early soldering intestinal obstruction
Abscesses of the abdominal cavity
Bleeding from the mesenterial artery
Insolvency of the stitches

4. Complications of the acute appendicitis
(lately postoperative)
Soldering intestinal
obstruction
Postoperative
ventral hernias

5. Appendicular infiltrate
- Inflammatory conglomerate, contents of the inflammated appendix in the
centre, around which there are the loops of the small and thick intestines,
omentum, attached to the parietal peritoneum.
Acute appendicitis
Appendicular infiltrate
3-5 days

6. MSCT at the appendicular infiltrate

7. The diagnosis of the appendicular infiltrate
stating on the base of:
•Complaints: pain in the right iliac
area
•Anamnesis: beginning of the
disease as at the acute
appendicitis, the time after the
beginning is about 3-5 days
•Examination: subfebril temperature
of the body, tachycardia, in the
right iliac area the thick and painful
formation, attached to the iliac
bone is palapated.
Marking of the borders of the
appendicular infiltrate

8. TREATMENT OF THE APPENDICULAR
INFILTRATE
CONSERVATIVE
1.Bed mode
2.Table №4
3.Antibiotics with the wide spectre of the
actions
4.Vitamins
5.Detoxication therapy
If at the phone of treatment of the appendicular infiltrate, the surgical treatment
Surgical treatment

9. Differences between the appendicular infiltrate
and abscess
Appendicular infiltrate Appendicular abscess
Subfebrile temperature Hectic temperature
Without the rising of the
leucocytes
Leukocytosis with the increasing
Reduction of the sizes of the
infiltrate
Increasing of the sizes of the
infiltrate with the soft centre
The fluctuation symptom is
negative
The fluctuation symptom is
positive
US: there is no the liquid in the
centre of the formation
US: there is the liquid in the centre
of the formation

10. Describing with game: drawing the
abdomenal wall of two person.
1-person: T-37,5-37,6-37-36,9*C
2-person: T-37,8-38-38,5-39*C

11. Diffuse peritonitis – serious
complication of the acute
appendicitis

12. Local peritonitis – install one drainage
into the pelvis or right iliac area
Diffuse peritonitis – install two drainages
Total peritonitis – drainage by the
method of our clinic

13. я
Method of our clinic

14. Pilephlebitis – festering
thrombophlebitis of the
branches of the portal vein
0
00
0
0

15. Treatment of the pilephlebitis
hepatoprotectors
detoxication
Antibacterial therapy
Rheological drugs

16. Treatment of the abscess of
the liver

17. The most frequent localization of the
abscesses in the abdominal cavity

18. Instrumental examination of the abscesses

19. Abscess of Douglas’s space

20. Abscess of the pelvis
(research by finger)

21. Open of the abscess of pelvis
Transvaginal Transrectal

22. Open of the abscess of pelvis by Jackson-
Elem

23. Intraintestinal abscess

24. Abscess of the subdiaphragmal
space

25. Open of the abscess of the subdiaphragmal
space

26. Open of the abscess of the subdiaphragmal
space by Melnikov

27. Acute soldering intestinal
obstruction – chalices of Kloyber

28. US criterion of the acute intestinal
obstruction

29. Three balloons test at the acute intestinal
obstruction
AIO - AIO +
1
2
3
1,2,3

30. Treatment algorithm
All the patients with the AIO must stay at the surgical
department
AIO + peritonitis
Operation
Yes No
Conservative actions
(during 2 hours)
Effective
Not effective
Operative treatmentExamination and planned
treatment

31. Main directions of the conservative
therapy
Decompression
of the stomach
and intestine
Action onto the
vegetative
nervous system

32. Decompression of the gastrointestinal
patch
Liberation of the distal part of
the GIP
Liberation of the proximal part of
the GIP
Siphon
enema
Cleaning enema
Washing of
the stomach
Intubation of
the intestine

33. Technique of the siphon enema

34. Dissection of the soldering.
Laparoscopic
dissection of the
soldering

35. Not formed intestinal
fistula
Tube intestinal
fistula
Lip intestinal
fistula

36. Plastic of the anterior abdominal wall by
Voznesenskiy