Appendicitis

Appendicitis is an inflammation of appendix . a 31/2 inch long tube of tissue that extends from the large intestine.

Appendicitis may be presented in one of the following way

  • Subacute appendicitis – Less severe form of appendicitis
  • Acute Appendicitis- Most severe form of appendicitis. Patient feels severe pain during acute appendicitis
  • Recurrent Appendicitis- Recurrent attack of acute appendicitis.
  • Chronic appendicitis-Mild pain present for a long period of time
  • Gangrenous Appendicitis-Blood supply of appendix become hampered and appendix become gangrenous. This is a very severe and dangerous form of appendicitis because it may perforate and may cause Peritonitis.
  • Apendicular Lump – Mesentry and bowel become adherent to inflammmed appendix. If it is not treated surgically before 48 -72 hrs of acute appendicitis presented as a lump in Right Illiac Fossa.
  • Appendicular absecess: Sometime pus filled absecess from outside the inflammmed appendix . Scar tissue then wall of the appendix from rest of abdomen preventing infection from spreding. An absecessed appendix is a less urgent situation but unfortunately it can”t always be identified without surgery.

So appendicitis is a Medical emergency that required prompt surgery to remove the appendix. If left untreated and inflamed appendix may eventually burst or perforate

Spilling infection into abdominal cavity ehich can lead to Peritonitis which may be fetal to life.

SYMPTOMS

  • Migrtaing pain: Typically pain started around the umbilicus which shifted to Right Lower part of abdomen.
  • Loss of apetite
  • Nausea or vomiting soon after abdominal pain begins
  • Temprature 99 to 102F
  • Abdominal Swelling in Right lower abdomen in case of appendicular lump formation.
  • constipation with diarrhea
  • Some atypical symptoms may appear including dull or sharp pain anywhere upper and lower abdomen, painful urination, vomting that precedes abdominal pain

Diagnosis

  • Blood Investigations-CBC
  • Ultrasonography

Treatment

1. Conservative treatment: when appendicular lump formed patient treated with IV Fluid and IV antibiotics and analgesic and surgical treatment performed after 6 weeks

2. Surgical Treatment: Appendisectomy: This is the technique to remove appendix which may be performed by two ways

  • open appendicectomy: this is performed via a incision in Rt Lower abdomen.
  • Laproscpic appendicectomy: This is performed via 2 or 3 small puncture holes for a laproscope and instruments. Appendix is visualized on TV screen via laroscope , instruments are used to catch the appendix and to cut the appendix at its base then appendix is carried out from one of its Key Hole. Patient discharged on same day or after one night stay. Patient feels lesser painand require lesser amount.