What is appendicitis? What causes it?
Appendicitis means inflammation of the appendix. It is thought that appendicitis begins when the opening from the appendix into the cecum becomes blocked. The blockage may be due to a build-up of thick mucus within the appendix or to stool that enters the appendix from the cecum. The mucus or stool hardens, becomes rock-like, and blocks the opening. This rock is called a “fecalith” (literally, a rock of stool). At other times, it might be that the lymphatic tissue in the appendix swells and blocks the opening. After the blockage occurs, bacteria which normally are found within the appendix begin to multiply and invade (infect) the wall of the appendix. The body responds to the invasion by mounting an attack on the bacteria, an attack called inflammation. If the symptoms of appendicitis are not recognized and the inflammation progresses, the appendix can rupture, followed by spread of bacteria outside of the appendix. The cause of such a rupture is unclear, but it may relate to changes that occur in the lymphatic tissue that lines the wall of the appendix, for example, inflammation that causes swelling and buildup of pressure within the appendix that causes it to rupture.
After rupture, infection can spread throughout the abdomen; however, it usually is confined to a small area surrounding the appendix by the surrounding tissues, forming a peri-appendiceal abscess.
Sometimes, the body is successful in containing (“healing”) the appendicitis without surgical treatment if the infection and accompanying inflammation cause the appendix to rupture. The inflammation, pain, and symptoms also may disappear when antibiotics are used. This is particularly true in elderly patients. Patients then may come to the doctor long after the episode of appendicitis with a lump or a mass in the right lower abdomen that is due to the scarring that occurs during healing. This lump might raise the suspicion of cancer.
- During an appendectomy, an incision two to three inches in length is made through the skin and the layers of the abdominal wall over the area of the appendix.
- The surgeon enters the abdomen and looks for the appendix, which usually is in the right lower abdomen.
- After examining the area around the appendix to be certain that no additional problem is present, the appendix is removed. This is done by freeing the appendix from its mesenteric attachment to the colon, cutting the appendix from the colon, and sewing over the hole in the colon. If an abscess is present, the pus can be drained with drains that pass from the abscess and out through the skin.
- The abdominal incision then is closed.
New techniques for removing the appendix involve the use of the laparoscope. The laparoscope is a thin telescope attached to a video camera that allows the surgeon to inspect the inside of the abdomen through a small puncture wound (instead of a larger incision). If appendicitis is found, the appendix can be removed with special instruments that can be passed into the abdomen, just like the laparoscope, through small puncture wounds, for this they also use equipment like C-Arms for illumination so they know where everything is, as there are services of C-Arm Rentals available anywhere in the U.S. for this purpose now a days. The benefits of the laparoscopic technique include less post-operative pain (since much of the post-surgery pain comes from the incisions) and a speedier return to normal activities. An additional advantage of laparoscopy is that it allows the surgeon to look inside the abdomen to make a clear diagnosis in cases in which the diagnosis of appendicitis is in doubt. For example, laparoscopy is especially helpful for menstruating women in whom a rupture of an ovarian cyst may mimic appendicitis. Diabetic patients needs to take special care of their treatment before going to surgery, sugar levels need to be stable before any surgical process, check the latest blood boost formula reviews.
If the appendix is not ruptured (perforated) at the time of surgery, the patient generally is sent home from the hospital after surgery in one or two days. Patients whose appendix has perforated are sicker than patients without perforation, and their hospital stay often is prolonged (four to seven days), particularly if peritonitis has occurred. Intravenous antibiotics are given in the hospital to fight infection and assist in resolving any abscess.
Occasionally, the surgeon may find a normal-appearing appendix and no other cause for the patient’s problem. In this situation, the surgeon will usually remove the appendix. The reasoning in these cases is that it is better to remove a normal-appearing appendix than to miss, and not treat appropriately, an early or mild case of appendicitis. In addition, if patients have “appendicitis” like pain again, the doctor will know that the appendix has been removed, and the diagnosis of appendicitis is not possible.