Appendicitis
From ArticleWorld
Appendicitis is a medical condition characterized by the inflammation of the appendix. Some cases can be resolved without treatment, but most of them require special (and urgent treatment). Left untreated, it can be mortal, due to peritonitis or shock.
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Causes of appendicitis
The causes of appendicitis are yet unknown. However, the leading theory suggests that the main cause is the obstruction of the appendiceal orifice, because of fecal matter stuck in the orifice, tumors or blood clots. This obstruction causes a distension of the appendix. The distension causes the appendix to apply a greater pressure on the blood vessels, obstructing blood flow. Without enough blood, the appendix loses its ability to fight against infectious agents, allowing fecal bacterial to grow beyond control. Depending on how severe the infection is, symptoms will vary.
Symptoms
In a typical appendicitis case, the first symptom is pain, at first in the center of the abdomen, and then in the lower-right part of the abdomen. Other symptoms include loss of appetite, fever, nausea and vomiting. Some typical cases are associated with a mild numbness. Diagnosis is very easy and medical intervention can be done very quickly.
Atypical cases' symptoms include suppuration, severe pain in lower quadrant. Rebound tenderness in the lower-right abdomen suggests a possible case of peritonitis, and guarding of abdomen is almost always associated with peritonitis. The diagnosis of atypical cases is very difficult, often taking a few days, and the surgery often reveals a perforated or severely infected and suppurating appendix.
Diagnosis
Diagnosis is done using a wider range of techniques. The classical finding is pain in the umbilical region, but later discoveries introduced blood tests, digital rectal exams and a number of signs like Blumberg's Sign. Where available, CT scan is the preferred method.
Treatment
Typical treatment involves the removal of the appendix through a surgical operation is called appendicectomy. However, if the appendix is ruptured, a laparotomy is unavoidable. It is not uncommon today for the operation to be performed using a laparoscopic approach, or a small camera to visualize the area of interest. In order to reduce inflammation and destroy any surviving bacteria, antibiotics are administrated, sometimes intravenously.
Prognosis
Most patients only require treatment to cure appendicitis. However, complications may occur, especially if the appendicitis is left untreated and peritonitis occurs. In fact, this is the reason why appendicectomy should be performed as quickly as possible. Appendicitis itself is not mortal, but it leads to peritonitis which, if untreated, can lead to death.
Sometimes, typical appendicitis will resolve spontaneously. Atypical appendicitis is more difficult to treat. In both cases, diagnosis and appendicectomy have the best results, leading to a 2 to 4 weeks recovery.