A blind-ended tube connected to a pouch like structure i.e. cecum, is known as Appendix. It develops from cecum embryologically. The cecum is a structure of colon which is located at the junction of both intestines (small and large).
The appendix rests on the junction of the small intestine and large intestine. It is a thin tube of approximately four inch length. Normally, the appendix is located in the lower right- hand side of the abdomen. Appendicitis pain may initiate in the middle part of the abdomen.
The most common signs and symptoms of Appendicitis in adults and children are listed below.
Symptoms of Appendicitis in children of age 2 and less are listed below:
Older children and teenagers may show following symptoms:
Causes of appendicitis are unknown in most of the cases. There is possibility of many reasons behind the occurrence of appendicitis. According to medical professionals, an obstruction in the appendix may lead to the appendicitis. Partial and complete obstruction; both can be responsible for the occurrence of appendicitis. An accumulation of fecal matter may lead to obstruction. The other possible reasons behind the obstruction are listed below:
There are chances of multiplication of bacteria inside the organs surrounding the colon when there is obstruction in the appendix. This enhances formation of pus which puts additional pressure and it can be painful. As a result of this process, local blood vessels get compressed and there can be generation of gangrene due to lack of blood flow to appendix. A medical emergency may arise if the appendix rupture takes place and fecal matter can fill into the abdomen.
After physical examination, the physician may ask for detail symptoms to determine presence of appendicitis. Diagnostic tests recommended for the detection of appendicitis are given below:
Diagnosis of appendicitis is difficult since the position of appendix in the abdomen may vary. The location of appendix is at the lower right side of abdomen most of the times. Appendix gets attached to the other structures in the abdomen through a sheet-like membrane structure called mesentery. Larger mesentary allows appendix to move around and as a result of this, appendix keeps moving down to the other organs such as pelvis and colon. Because of this, inflammation of the appendix looks like the inflammation of other organs. Diagnosis of appendicitis can also be difficult when inflammatory problems resemble with it. Right side diverticulitis is an example of it. Since this is the case, patients with possible appendicitis are commonly kept under observation to distinguish between appendicitis and other conditions.
Post operation, there is a possibility that, small portion of appendix may remain behind. There are chances of inflammation of this remaining piece of appendix and it can lead to further complications of appendicitis. Hence, it is possible to observe recurrence of appendicitis in case of patients who have previously undergone appendicitis surgery. Stump appendicitis is acute inflammation of the residual appendix which mostly occurs after laparoscopic appendectomy. It results from obstruction of the lumen of appendix which is left behind post surgery in some cases. Since there is possibility of rupture of stump as a result of insufficient diagnosis and treatment, early diagnosis is recommended.
Based on the diagnosis, need of surgical treatments is decided. Antibiotics are recommended prior to the surgery in most of the cases. Medication helps prevent post-operative infections. Surgical removal of appendix is known as Appendectomy. Based on the severity of appendicitis, open appendectomy or a laparoscopic appendectomy is performed.
An incision in the lower right side of the abdomen is made by the surgeon during an open appendectomy. Appendix is removed and wound is closed with the aid of stitches. During this process, abdominal cavity can be cleaned in case of appendix burst inside the abdomen.
As the name indicates, this surgery involves use of laparoscope. Few small incisions are made in the abdomen and laparoscope is inserted into these incisions during the surgery. A laparoscope is a long and thin tube having camera on the front side. Images of the abdominal area can be displayed on the screen which helps in observing abdomen and performing surgery using the instruments. After finding the appendix, it is tied with the aid of stitches and then removed. After this, dressing and cleaning processes are performed.
Appendicitis cannot be prevented as such, but there are some precautions which can reduce its risk. There is less frequency of occurrence of appendicitis in the people with high fiber diet. A healthy diet containing fresh vegetables and fruits is helpful in increasing fiber intake. Timely medical advice is recommended, since untreated appendicitis can lead to medical emergency.
Perforation is the most frequently generated complication of appendicitis. It can lead to a Peri-appendiceal abscess which is collection of infected pus. This occurs as a result of delaying the diagnosis and treatment of appendicitis. If there is no improvement after the use of antibiotics in the patients of appendicitis, surgical treatment needs to be initiated without delay to avoid further complications.
A comparatively common complication of appendicitis is blockage or obstruction of the intestine. Compression of intestine because of the inflammation surrounding the appendix causes blockage. This blockage restricts the passage of intestinal contents. If the intestinal area above the blockage gets filled with liquid and gas, swelling of abdomen takes place and further results in nausea and vomiting. Therefore, it becomes necessary to remove the contents of the intestine using a tube passed through esophagus and nose and into the stomach and intestine.
Below are some conditions that can mimic appendicitis even when it is not actually present.
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