The Maravi Post

APPENDICITIS means inflammation of the appendix. It is a medical emergency.

What is the Appendix?

The appendix is a thin tail, tube or appendage growing out of the caecum, which is part of the large intestine located on the lower right side of the abdomen. The exact function of the appendix in the human body is currently unknown.

What is Appendicitis?

Appendicitis means inflammation of the appendix. Food or faecal matter can sometimes lodge in the narrow tube of the appendix, and the blockage becomes infected with bacteria. This is a medical emergency. If the appendix bursts, its infected contents will spread throughout the abdominal cavity. Infection of the lining of the abdominal cavity (peritonitis) can be life threatening without prompt treatment.

Anyone of any age can be struck by appendicitis, but it seems to be more common during childhood and adolescence. It is less common for anyone over the age of 30 years to develop appendicitis. Treatment options include surgery.

Symptoms of appendicitis:

The primary symptom is pain in the stomach. This pain usually starts in the middle of your child’s belly and might feel like a dull cramp. Over the next few hours, the pain becomes sharper. Sometimes the pain can shift from being all over the tummy to the lower right side of the belly, over the appendix. Your child might be more uncomfortable when she/he’s trying to sit upright or walk straight. The pain will often get worse when he/she moves. Other symptoms include:
·    Pain in the lower back, hamstring or rectum
·    Fever
·    Vomiting
·    Diarrhoea or constipation
·    Loss of appetite

Cause of appendicitis:

The cause of acute appendicitis is still unclear. A number of studies have indicated that obstruction of the appendix usually occurs during appendicitis, while others dispute that obstruction is the cause of appendicitis. Often, a small amount of faecal matter is present in the appendix at the time of the appendicectomy.

Diagnosis of appendicitis:

Appendicitis can mimic the symptoms of other disorders such as gastroenteritis, ectopic pregnancy and various infections (including those of the kidney and chest). Appendicitis can be more difficult to diagnose in children than in adolescents or adults because the symptoms aren’t as clear in children.

Diagnosis may include a thorough physical examination and careful consideration of the symptoms. If the diagnosis is not clear, then laboratory tests and ultrasound or CT scans may be needed.

Perforated appendix

If pus builds up in the appendix, it will eventually burst, flooding the abdominal cavity with infected matter. Bursting, or perforation, can occur 36 hours or so from the onset of infection. The signs of a perforated appendix include a severe worsening of symptoms and collapse.  Infection of the lining of the abdominal cavity (peritonitis) is a life-threatening complication and requires immediate emergency treatment.

Treatment for appendicitis

The only available treatment is surgical removal of the appendix. This procedure is known as an appendicectomy or appendectomy. The appendix can often be removed using laparoscopic (keyhole) surgery. The surgeon will use a slender instrument (laparoscope), which is inserted through tiny incisions (cuts) in the abdomen. This eliminates the need for an abdominal incision (cut).

If this is not possible, a small incision is made in the lower abdomen. The appendix is cut away and the wound on the large intestine stitched. If the appendix has burst, the surgeon will insert a tube and drain the abdominal cavity of pus. Antibiotics are given to the patient intravenously to reduce the possibility of peritonitis.

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