Appendicitis
Appendicitis is an inflammation of the appendix. The appendix is a small finger like pouch attached to the large bowel. Appendicitis occurs in one to two people per thousand annually making it one of the most common surgical emergencies to present to the emergency rooms in the United States. It is most likely to occur between the ages of ten and thirty but can occur at any age. Appendicitis is considered a medical emergency due to the high risk of rupture which can cause infection and increase mortality from the disease.
Symptoms of Appendicitis
Classic symptoms of appendicitis include abdominal pain often beginning at the belly button area then localizing to the right lower quadrant of the abdomen. The pain is usually made worse with movement and classically the patient will not want to move and will guard the abdomen. A loss of appetite with nausea and possibly vomiting and a low grade fever are usually present. The patient may have diarrhea or constipation. She may feel the need to pass gas but be unable to do so. The abdomen may be swollen. The pain is generally sudden and may wake the patient up at night. Not all patients have all these symptoms.
Causes and diagnosis of Appendicitis
Why appendicitis occurs in some people and not others isn’t clearly understood. One theory is that the appendix becomes blocked and a bacterial or viral infection causes it to swell and become inflamed.
Diagnosis of appendicitis is made by history, physical exam and tests. Your doctor will perform blood test to check for infection such as elevated white blood cell counts. A CT which is a special form of X-ray may be ordered or possibly and Ultrasound.
Treatment of Appendicitis
In cases that are ambiguous you may be admitted to the hospital, placed on intravenous fluids and antibiotics and observed. If your condition shows marked improvement you may be discharged. In most cases however, surgical intervention is the treatment of choice as the risk of rupture of the appendix and the increase in complications and mortality from peritonitis that brings are considered not worth the risk of waiting. This risk of rupture is what makes appendicitis an emergency.
As with all surgeries there are risk of bleeding and infection even without rupture of the appendix. In approximately twenty percent of cases the appendix will already be ruptured before the patient seeks treatment. Rupture causes pus and bacteria to be spilled into the abdominal cavity. In such cases the mortality rate is much higher. There seems to be a higher risk of this occurring in children under two and patients over seventy. Rupture tends to occur most often in 36 to 72 hours after the onset of symptoms. Surgery and be done laparoscopically in many cases but sometimes requires an open incision.
If appendicitis is caught early and treated quickly recovery is generally rapid and complications are few.
Sources:
<http://digestive.niddk.nih.gov/ddiseases/pubs/appendicitis/>
<http://www.dekalbsurgical.com/appendicitis.html>
This article is informational and not medical advice. Always follow up with your doctor for questions regarding your health care.
>
| |
