Saturday, July 16, 2011

Acute Appendicitis in Nutshell

Appendix is located inside of abdomen in the right side lower abdomen; very rarely in right lower abdomen. It is a redundant portion of large intestine, a narrow calibered tubular structure similar to intestine.
Inflammation of appendix is termed as appendicitis.
  • Pain in right side lower abdomen,
  • Vomiting, 2 to 3 times after it; and
  • Fever, 4 to 6 hours after pain; in that order are the classical symptoms of appendicitis.
Typically, the pain starts around the umbilicus and shifts to right side of lower abdomen and settles there; patient may feel difficult to walk, gets pain if coughs, tries to remain still on the bed and not move about. Patient may experience pain on pressure on the right lower abdomen, muscle tightness over the area; and may even feel pain on the skin surface, if, a hand swept over it.
Vomiting typically occurs for 2 to 3 times after the pain and usually stops after the contents of stomach are vomited out.
Fever may come with rigor and chill; may shoot up to 102 degree Fahrenheit.
The appendicitis is notorious for its resemblance of its features with many other diseases. Basically, the diagnosis of appendicitis is clinical and is fairly accurate.
In equivocal cases the investigations such as ultrasonogram in experienced hands is supportive, some cases also can not be confirmed in this investigation. Computerized tomography (CT) may aid in diagnosing appendicitis. Recently, multi detect computerized tomography has been seen to give less false positive and false negative results, and can be relied to larger extent.
Still, all these facilities are not available widely, and clinician has to rely on available tools and on his clinical experience.Laparoscopic appendectomy.Image of Laparoscopic Appendicectomy

Laparoscopic appendicectomy is a little better than the open procedure. However, it is again not available in many places. In some suspected cases, after ruling out other common causes for such type of features, an appendicectomy can be done; that also relieves the symptoms.
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