Appendicitis
If you have appendicitis, your appendix usually needs to be removed as soon as possible. This operation is known as an appendectomy or appendicectomy.
Surgery is usuallyalso recommended if there's a chance you have appendicitis but it's not been possible to make a clear diagnosis.
This is because it's considered safer to remove the appendix than run the risk of the appendix bursting.
In humans, the appendix doesn't perform any important function and having it removed doesn't cause any long-term problems.
Appendectomies are carried out under general anaesthetic using either a keyhole or open technique.
Keyhole surgery (laparoscopy) is usually the preferred method of removing the appendix because the recovery tends to be quicker than with open surgery.
This operation involves making three or four small cuts (incisions) in your tummy (abdomen). Special instruments are then inserted, including:
Once the appendix has been removed, the incisions will usually be closed with dissolvablestitches .Regular stitchesmay also be used, which need to be removed at your GP surgery 7 to 10 days later.
In some circumstances, keyhole surgery isn't recommended and open surgery is performed instead. These include:
In these cases, the operation involves making a single larger cut in the lower right-hand side of your abdomen to remove the appendix.
When there's widespread peritonitis infection of the inner lining of the abdomenit's sometimes necessary to operate through a long cut along the middle of the abdomen in a procedure called a laparotomy.
As with keyhole surgery, the incisionis closed using either dissolvable stitches or regular stitchesthat need to be removed at a later date.
After both types of surgery, the removed appendix is routinely sent to a laboratory to check there are no signs of cancer. This is a precautionary measure, although it's rare for a serious problem to be found.
One of the main advantages of keyhole surgery is the recovery time tends to be short and most people can leave hospital a few days after the operation.
If the appendix is operated upon promptly, most patients can go home within 24 hours. With open or complicated surgery for example, if you have peritonitis it maytake up toa week before you're well enough to go home.
For the first few days after the operation you're likely to experience some pain and bruising. This improves over time, but you can take painkillers if necessary.
If you had keyhole surgery, you may experience pain in the tip of your shoulder for about a week. This is caused by the gas that was pumped into the abdomen during the operation.
You may also experience some short-term constipation . You can help reduce this by not taking codeine painkillers, eating plenty of fibre, andstaying well hydrated. Your GP can prescribe medication if the problem is particularly troublesome.
Before leaving hospital, you'll be advised about caring for your wound and what activities you should avoid.
In most cases, you can return to normal activities in a couple of weeks, although more strenuous activities may need to be avoided for four to six weeks after open surgery.
While you recover, it's important to keep an eye out for signs of any problems.
Contact the hospital unit where the appendectomy was performed or your GP for advice if you notice:
These symptoms could be a sign of infection.
Appendectomies are one of the most commonly performed operations in the UK, and serious or long-term complications are rare.
However, like all types of surgery, there are some risks. These include:
The use of general anaesthetic also carries some risks, such as the risk of an allergic reaction or inhaling stomach contents, leading to pneumonia . However, serious complications like this are very rare.
In some cases, appendicitis can lead to the development of a lump on the appendix called an appendix mass.
This lump, consisting of appendix and fatty tissue, is an attempt by the body to deal with the problem and heal itself.
If an appendix mass is found during an examination, your doctors may decide it's not necessary to operate immediately.
Instead, you'll be given a course of antibiotics and an appointment will be made for an appendectomy a few weeks later, when the mass has settled.
Another possible alternative to immediate surgery is the use of antibiotics to treat appendicitis.
However, studies have looked into whether antibiotics could be an alternative to surgery and as yet there isn't enough clear evidence to suggest this is the case.
The appendix is a rudimentary 5-10 cm elongation at the end of the small intestine and at the beginning of the colon, which bears no known function.
The symptoms of appendicitis are not always uniform among patients. However, abdominal pain is always present. Usually this type of pain begins in the solar plexus, accompanied by nausea, and after a few hours, the pain becomes concentrated in the lower right quadrant of the abdomen, right next to the thigh. Symptoms include: 1. Nausea 2. Loss of apetite 3. Diarrhea 4. High fever 5. Flushed face
It is important that all patients suffering from any kind of severe abdominal pain which lasts for several hours and becomes worse over time, should refer themselves to a medical professional. When there are typical symptoms of appendicitis, the condition is easy to diagnose (abdominal pain, nausea, fever etc). These common symptoms are only present in half of the cases. There are cases of atypical appendicitis, which exhibit other symptoms, such as constipation, atypical pain, diarrhea, etc. In order to diagnose this condition, several examinations are conducted: 1. A blood test (usually shows elevated white blood cells) 2. A pregnancy test (in order to rule out a potential pregnancy) 3. A urine test (in order to check for infection) 4. Abdominal echo (in order to check for fluid in pouch of Douglas) 5. Scanner of the appendix (which will show the shape and size of the appendix)
If the diagnosis of appendicitis is confirmed, treatment is always surgical. This procedure is called an appendectomy. This procedure is conducted under general anesthesia, and it can be performed via a probe (laparoscopy), or via open surgery. The procedure involves removing the appendix. A laparoscopy is performed after blowing the abdomen up by blowing gas into it. This renders certain channels available, so that the physician may insert the laparoscope. Following this, the physician performs the procedure via a monitor. A laparoscopy is favorable, because it does not require open surgery, lowers risks and allows the patient to recover more efficiently. If the patient presents themselves too late at the hospitals, the bacteria from the infection in the appendix may spread to other organs in the abdomen (the appendix may burst), then treatment is rendered more complicated, and other medication needs to be used in conjunction to surgery, such as antibiotics to fight infection, analgesics to treat pain, antipyretics to treat the fever and intravenous injections etc.
Neglecting to pay the appropriate attention to a case of appendicitis can be life-threatening. The appendix may burst and cause peritonitis. Peritonitis is a very severe condition, which occurs as a consequence of the spread of bacteria from the burst of the infected appendix. The bacteria spread via the blood in the entire body. This causes inflammation of the peritoneum (the lining which covers all of the organs in the abdomen). Peritonitis has the following symptoms: severe pain spread all over the abdomen, the patient feels fatigue, very high fever, tachycardia (rapid heart rate), difficulties breathing, swelling and hardening of the abdomen, the patient is nearly in shock. This condition requires immediate surgical intervention. An appendectomy is performed, as well as a cleanse of the belly. Following this, that patient has to remain in hospital for a prolonged period in order to receive the proper medication. At times, following the surgical procedure, a small tube is left protruding from the stomach in order to allow for drainage of the infected fluids. This is then later removed.