Friday, September 25, 2009
Appendicitis
What is Appendicitis?
Appendicitis is inflammation of the appendix, a small pouch attached to the cecum, the beginning of the colon, on the lower right side of the abdomen. The appendix is not necessary for life, but it can become diseased. If untreated, an inflamed appendix can burst, causing infection and even death. Appendicitis can affect people at any age. It is most common in people ages 10 to 30.
The cause of appendicitis is usually unknown. It may occur after a viral infection in the digestive tract or when the opening connecting the large intestine and appendix is blocked. The inflammation can cause infection, a blood clot, or rupture of the appendix. Because of the risk of rupture, appendicitis is considered an emergency. Anyone with symptoms needs to see a doctor immediately.
Symptoms of Appendicitis
The most common symptoms of appendicitis are:
pain in the right side of the abdomen
nausea
vomiting
constipation
diarrhea inability to pass gas
low fever that begins after other symptoms
abdominal swelling
anorexia
The pain usually begins near the navel and moves down and to the right. The pain becomes worse when moving, taking deep breaths, coughing, sneezing, and being touched in the area.
Not everyone with appendicitis has all the symptoms. People with symptoms of appendicitis should not take laxatives or enemas to relieve constipation because these medicines could cause the appendix to burst. Pain medicine can mask symptoms that the doctor needs to know about, so it should not be used before consulting a doctor when appendicitis is suspected.
The doctor bases an appendicitis diagnosis on symptoms, a physical exam, blood tests to check for signs of infection such as a high white blood cell count, and urine tests to rule out a urinary tract infection. Usually doctors use CT scan or ultrasound to see whether the appendix looks inflamed.
If the diagnosis of appendicitis is not certain, people with equivocal signs of appendicitis may be watched and sometimes treated with antibiotics. People with definite appendicitis have surgery to remove the appendix, which is called an appendectomy. Doctors may use laparoscopic surgery for appendectomy. This technique involves making several tiny cuts in the abdomen and inserting a miniature camera and surgical instruments. The surgeon then removes the appendix with the instruments, so there is usually no need to make a large incision in the abdomen. People can live a normal life without their appendix--changes in diet, exercise, or other lifestyle factors are not necessary.
Causes and Risk Factors of Appendicitis
Appendicitis can occur in persons of any age, but it is most prevalent in young adults. It tends to occur on its own with no particular cause.
Treatment of Appendicitis
The surgery that corrects appendicitis, called an appendectomy, is a procedure with relatively little risk. Normally, the patient stays in the hospital for less than a week and can usually count on being back to a normal routine in three weeks. Many surgeons are performing laparoscopic appendectomy in which the appendix is removed through three small incisions (less than half an inch long) using special instruments and a special camera. With laparoscopic appendectomy, most patients can go home within 24 hours of the operation. However, if the appendix is ruptured, the patient may need to stay in the hospital for a considerably longer period of time and the risk of complications is much greater. A very ill patient may require special measures, such as stomach tubes and intravenous medications. If such complications have occurred, it may be two to three months before the patient can resume normal activity. Once the useless appendix is removed, there is no danger of appendicitis recurring.
Laparoscopic Surgery
Minimally invasive surgery performed with the aid of a tiny camera threaded into the abdomen has transformed some forms of abdominal surgery. For example, 80 to 90 percent of gallbladder operations are done using laparoscopy. Now a number of doctors are using the same technique to remove the appendix.