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Home :: Digestive Disorders

Acute Appendicitis

 

Acute Appendicitis
Acute Peritonitis
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The appendix is a blind-ended outgrowth tube about 1-9 cm long, which projects from the caecum, that is, the first part of the large intestine. It is located close to the ileocaecal junction. In the case of acute appendicitis, the vermiform appendix quickly becomes swollen and dies. Appendicitis may occur after a viral infection in the digestive tract or when the tube connecting the large intestine and appendix is blocked by trapped stool. Appendicitis may occur after a viral infection in the digestive tract or when the tube connecting the large intestine and appendix is blocked by trapped stool.

An obstruction of the lumen of the appendix by fecal matter leads to an inflammation of this organ, accumulation of fluids, distention and pain. Venous engorgement takes place and bacteria multiply. If no treatment is commenced, the appendix gets infected, an abscess will develop or it will rupture leading to contamination of the peritoneum. The inflammation can cause infection, a blood clot, or rupture of the appendix. The inflammation can cause infection, a blood clot, or rupture of the appendix. Because of the risk of rupture, appendicitis is considered an emergency. Alternatively, particularly where perforation or gangrene occurs after 24 hours, the peritonitis may be localised, or the inflamed appendix may be surrounded by omentum to form an appendix mass or abscess.

Appendicitis (or epityphlitis ) is a condition characterised by inflammation of the appendix . Symptoms of appendicitis include abdominal pain, fever, and vomiting. It is one of the top three conditions leading to pediatric abdominal surgery. Acute appendicitis is considered to be a surgical illness and its treatment consists of removing the affected appendix. The surgical procedure used in acute appendicitis is called appendectomy and it needs to be performed as soon as possible, in order to prevent the development of complications. Although uncommon, appendicitis is very serious, and difficulty in diagnosing appendicitis in the emergency department makes appendicitis the 3rd leading cause of malpractice lawsuits. The swelling and inflammation perturb the normal blood circulation to the appendix and eventually the appendix stops receiving blood.

Appendicitis is when your appendix becomes blocked and inflamed. The appendix is a small pouch attached to your large intestine, whose function is not well known. Obstruction of the lumen leads to distension of the appendix due to accumulated intraluminal fluid While mild cases may resolve without treatment, most require removal of the inflamed appendix, either by laparotomy or laparoscopy .The surgeon's goals are to evaluate a relatively small population of patients referred for suspected appendicitis and to minimize the negative appendectomy rate without increasing the incidence of perforation. However, abdominal pain occurs with many conditions and only an estimated 5% of cases of abdominal pain are actually appendicitis. If the appendix ruptures, infected and faecal matter enter the peritoneum, producing life-threatening peritonitis. Due to the fact that the appendix can be located in different regions of the lower abdomen, the pain can be misleading in establishing the appropriate diagnose. The next symptoms that occur in acute appendicitis are loss of appetite, nausea and vomiting. Most people with acute appendicitis feel an intensification of the abdominal pain while walking. Also, the pain may occasionally shift from the right side to the left side. Because of the risk of rupture, appendicitis is considered an emergency.

Causes of Acute Appendicitis

The common Causes of Acute Appendicitis :

  • Appendicitis is one of the most common causes of emergency abdominal surgery in the United States.
  • Fecaliths form when calcium salts and fecal debris become layered around a nidus of inspissated fecal material located within the appendix.
  • Infections that lead to swelling
  • Feces
  • The inflammation can cause infection, a blood clot, or rupture of the appendix.
  • Appendicitis usually occurs when the appendix becomes blocked by feces, a foreign object, or rarely, a tumor .
  • Lymphoid hyperplasia is associated with a variety of inflammatory and infectious disorders including Crohn disease, gastroenteritis, amebiasis, respiratory infections, measles, and mononucleosis

Symptoms of Acute Appendicitis

Some are common Symptoms of Acute Appendicitis :

  • Nausea
  • Vomiting
  • Constipation or diarrhea
  • Loss of appetite
  • Inability to pass gas.
  • Pain that intensifies when moving, taking deep breaths, coughing, or sneezing
  • Diarrhea.
  • low fever that begins after other symptoms
  • Abdominal swelling
  • Constipation.

Treatment of Acute Appendicitis

Here is the list of the methods for treating Acute Appendicitis :

  • The EMS provider must gather accurate "QRST" data including estimated fluid intake and loss, the child's weight gain or loss, and home remedies and interventions.
  • If the operation reveals that the appendix is normal, the surgeon will remove the appendix and explore the rest of the abdomen for other causes of your pain.
  • If a CT scan reveals an abscess from a ruptured appendix, the patient may be treated and the appendix removed later, after the infection and inflammation have gone away.
  • Antibiotics are often given intravenously to help kill remaining bacteria and thus reduce the incidence of infectious complication in the abdomen or wound.
  • Anecdotal reports describe the success of intravenous antibiotics in treating acute appendicitis in patients without access to surgical intervention (eg, submariners, individuals on ships at sea).
  • Treatment for actinomycosis is long term, generally with up to one month of intravenous penicillin G, followed by weeks to months of penicillin taken by mouth.
  • If the diagnosis is not clear, suggest observation in the hospital with frequent exam.
  • If there is a perforation, antibiotics should be started and may need surgical drainage of an abcess. The necessity of an appendectomy later is controversial.
  • Appendicitis is generally treated by surgical removal of the appendix.