VIM RUT THA CP

VIM RUT THA CPBi ging l thuyt lm sng Y6Bs L Hng

Gii phu ngoi khoa

i cng

Dch t hcBnh l ngoi khoa thng gp nhtCc nc phng Ty c tn sut b VRT cao hn cc nc Chu v Chu PhiT sut b VRT: 1/10.000 mi nmTr mi sinh n ngi gi, tui TB: 22t

Vi khun hca khunYm kh (Bacteroides fragilis)Hiu kh (E. coli)

Bin chngVim rut tha hoi thKhi vim rut thap-xe rut thaRut tha v m

Chn on

Chn on lm sngau chuynBun nn, nn iSt nh, HC p ng vim ton thnn au khu tr vng HCP, MB (+)Du hiu kch thch/vim phc mc HCP

Th lm sngau h chu phi (in hnh), h chu tri, h sn phi, h vKhi au h chu phi (khi vim hay p-xe rut tha)au lin tc (vim phc mc)Chng bng, b trung tin (tc rut)Tiu au, lt nht (nhim trng tiu), mt rn (HC trc trng)

Chn on cn lm sngTng s lng bch cu, t l neutrophileTng CRP (C-reactive protein)Siu m: du hnh bia, du n ngn tayCT scan: rut tha cng to, thnh dy v phn lp, dch quanh rut tha, phn ng vim quanh rut tha

Chn on phn bitPelvic inflammatory disease (PID) or tubo-ovarian abscessEndometriosisOvarian cyst or torsionUreterolithiasis and renal colicDegenerating uterine leiomyomataDiverticulitisCrohn diseaseColonic carcinomaRectus sheath hematoma

CholecystitisBacterial enteritisMesenteric adenitis and ischemiaOmental torsionBiliary colicRenal colicUrinary tract infection (UTI)GastroenteritisEnterocolitisPancreatitisPerforated duodenal ulcer

Siu m chn on

Vai tr ca CT scanChn on xc nhChn on bin chngChn on phn bit

Vim rut tha cp

p-xe rut tha

Khi vim ty rut tha

Vim rut tha th tc rut

iu tr

Vim rut tha cpPhu thut ct rut tha l phng php iu tr duy nhtCt ni soi: cha l tiu chun vng

Nguyn tc phu thutTm rut tha, xc nh gc rut thaCt mc treo trc khi ct gc rut thaX l gc rut tha: kp ri ct, buc hay khu bucVi gc rut tha: khng l yu cu bt buc

Ct rut tha, m m

Ct rut tha, ni soi

Dn lu p-xe rut tha ng bng

p-xe rut tha tiu khung

Dn lu p-xe rut tha ng m o

Bin chng sau mNhim trng vt mT dch, p-xe tn luChy muTc rut sm sau mVim phc mc do bc gc rut tha, thng hay hoi t mun hi trng hoc manh trng (m ni soi)

D hu v tin lngBin chng 4-15%, 1/3 s ny l nhim trng vt mT vong 0,2-0,8%, c th tng n 20%/BN trn 70Rut tha cha v m: t vong 0,1%. Rut tha hoi t: t vong 0,6%

HT