General Info about Appendicitis
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What happens in Appendicitis?
The danger with appendicitis is that the blocked appendix can burst leading to peritonitis. Peritonitis is infection of the peritoneum, the lining of the abdominal cavity.
Who is at risk in Appendicitis
Appendicitis is the most common cause for a child to need emergency abdominal surgery.
A risk factor is anything that increases a person’s chance of getting a disease such as Appendicitis.
Risk factors for Acute Appendicitis are factors that do not seem to be a direct cause of the disease, but seem to be associated in some way. Having a risk factor for Acute Appendicitis makes the chances of getting the condition higher but does not always lead to Acute Appendicitis.
Diet: People whose diet is low in fiber and rich in refined carbohydrates have an increased risk of getting appendicitis.
Seasonal variation: Most cases of appendicitis occur in the winter months - between the months of October and May.
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Appendix What are the symptoms of Appendicitis?
The most common symptom of appendicitis is abdominal pain on the right lower side of the abdomen. Features of abdominal pain How is Appendicitis diagnosed ?
Appendicitis is usually a clinical diagnosis and investigations are done to rule out other causes of abdominal pain. A history of a patient's symptoms is often the key to making an appendicitis diagnosis. When gathering the medical history, the doctor will ask about the nature, timing, location, pattern, and severity of the pain and other possible appendicitis symptoms like nausea, vomiting, fever and constipation. It is important to tell your doctor about: Any previous medical conditions and surgeries Before the physical examination , a nurse or doctor will usually measure vital signs, which include: Pulse rate The abdomen is next examined to confirm his suspicion. Location of the pain and tenderness is important. Pain is a symptom described by a patient; tenderness is the response to being touched. Certain specific signs will help to diagnose appendicitis. McBurney's sign - deep tenderness at McBurney’s point is a sign of acute appendicitis. Rebound tenderness - If gentle pressure is applied at the McBurney’s point, it will feel tender. If the pressure is released suddenly appendicitis pain often will feel worse which is due to inflammation of the peritoneum overlying the appendix area. Treatment for Appendicitis
The treatment of appendicitis is an immediate appendectomy, which may be done by the standard Open Appendectomy Technique, or through Laparoscopy. Appendectomy is usually performed as an emergency procedure. He is kept nil orally to prevent aspiration during anesthesia. Certain hospital formalities maybe required before hospitalization especially if you have private health insurance. Clarify the issue with the doctor or with the administrator. Sometimes authorization maybe required from your insurance service provider for the procedure. You may require packing your usual toiletries and a few clothes including undergarments, night wears for hospital stay. If the operation is done using Laparoscopy the stay in hospital may only be for a day or two whereas an open surgical procedure may require a 5 to 7 days stay. Before surgery or during the previous night a bath maybe advisable. During the bath thorough cleaning of the abdomen and genital area with soap and water a few times can help in lowering the bacterial count and lessen the chances of any infection from surgery. Appendicitis Open Surgery
The Open Appendectomy Technique is the surgery of choice if perforation of the appendix or appendicular abscess is suspected. Steps of surgery: The area around the appendix is examined to be certain that no complications of appendicitis The appendix is then removed which is done by freeing the appendix from its attachment to the abdomen and to the colon. The appendix is cut from the colon and sutures are placed over the hole in the colon. If an abscess is present, the pus is drained with drains (rubber tubes) that go from the abscess and out through the skin. After ensuring complete haemostasis the abdominal incision then is closed in layers. are present. Appendicitis Laparoscopic Surgery
Laparoscopic Appendectomy is often used if the diagnosis of Appendicitis is in doubt, or if it is desirable to hide the scars of surgery. A laparoscope is a thin telescope tube (from 5 to 10 mm diameter) with a magnifying glass-like eyepiece at one end to which a video camera is attached. Through the camera the view inside the abdomen can be seen on a television monitor. Steps of surgery: Appendicitis After Care
Recovery from a simple appendectomy is usually complete and rapid. Most patients can go home the day after the operation, and resume normal activities. The usual stay in the hospital after an appendectomy for an uncomplicated appendicitis is 1-3 days, depending on the age, other medical problems and physical condition of the patient. If the appendix is gangrenous or ruptured, the hospital stay may be 7 days or longer. Complications of Surgery
Complications are rare following an appendectomy. The most common complication of appendectomy is infection of the wound Appendicitis FAQsWho treats appendicitis? A general surgeon or a gastroenterologist treats appendicitis. Is appendicitis preventable? There is no known way to prevent appendicitis. However, if you are able to recognize appendicitis symptoms, you can prevent serious appendicitis complications from occurring. Removing the appendix is the only sure cut way of preventing appendicitis. This may be done if intrabdominal surgery is being performed for other reasons and the appendix is removed incidentally but it is not practiced as a routine. Does appendicitis always present with typical symptoms? Immunosuppressive therapy, Diabetes Mellitus, Chemotherapy and Obesity are some of the special conditions in which the patients may not have the typical set of symptoms for appendicitis and may simply experience a general feeling of being unwell. What are the Complications of appendicitis? The most serious complication of appendicitis is an infection of the lining of your abdominal cavity (peritonitis). This may occur if your appendix ruptures (perforates) and the contents of your intestines and infectious organisms invade the peritoneal cavity. Peritonitis is a medical emergency. Sometimes, infection and the seepage of intestinal contents may form an abscess, a walled-off area of infection (appendiceal abscess), it requires surgery before the abscess itself perforates, causing peritonitis. What are the symptoms of peritonitis? When the appendix ruptures, the patient may suddenly feel better. But soon after, the entire abdomen may become distended with gas and fluid and will likely feel tight, hard and tender to the touch. He may also have pain throughout the abdomen, but may not have the severe, localized pain of appendicitis. In addition, he may not be able to pass gas or have a bowel movement because of the inflammation. Other signs and symptoms may include a fever, thirst and a low urine output. Can appendicitis be treated with medicines? In some cases, infections may cause the same symptoms as appendicitis. Therefore, if an appendicitis diagnosis is uncertain, people may be watched and sometimes receive antibiotics as appendicitis treatment. If the cause of the pain is an infection, symptoms should resolve with intravenous antibiotics and intravenous fluids. However, if the patient has appendicitis, the condition cannot be treated with antibiotics alone and will require surgery. Are there long-term consequences of appendectomy? It is not clear if the appendix has an important role in the body in older children and adults. There are no major, long-term health problems resulting from removing the appendix although a slight increase in some diseases has been noted, for example, Crohn's disease. Appendicitis GlossaryAbdomen: The belly, that part of the body that contains all of the structures between the chest and the pelvis. The abdomen is separated anatomically from the chest by the diaphragm, the powerful muscle spanning the body cavity below the lungs. Abnormal: Not normal. Deviating from the usual structure, position, condition, or behavior. Anesthetic: A substance that causes lack of feeling or awareness. A local anesthetic causes loss of feeling in a part of the body. A general anesthetic puts the person to sleep. Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. Originally, an antibiotic was a substance produced by one microorganism that selectively inhibits the growth of another. Synthetic antibiotics, usually chemically related to natural antibiotics, have since been produced that accomplish comparable tasks. Appendix: A small out pouching from the beginning of the large intestine (the ascending colon). Formally called the vermiform appendix because it was thought to be wormlike. Complication: In medicine, an additional problem that arises following a procedure, treatment or illness and is secondary to it. A complication complicates the situation. CAT or CT scan: Computerized Axial Tomography scan. Pictures of structures within the body created by a computer that takes the data from multiple X-ray images and turns them into pictures on a screen. CT stands for computerized tomography. Fecolith: A hard stony mass of feces. A fecolith can obstruct the appendix, leading to appendicitis. Fever: Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). Incision: A cut. When making an incision, a surgeon is making a cut. Infection: The growth of a parasitic organism within the body. (A parasitic organism is one that lives on or in another organism and draws its nourishment there from.) A person with an infection has another organism (a "germ") growing within him, drawing its nourishment from the person.
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