The appendix is a small, finger-shaped pouch that projects out from your colon on the right-hand side. The appendix has no known purpose, but that doesn’t mean it can’t cause problems. Appendicitis is when the appendix is inflammed and filled with pus.
Anyone can develop appendicitis, but it most often strikes people between the ages of 10 and 30 and is one of the most common reasons for emergency abdominal surgery in children and the elderly.
Appendicitis may also follow an infection, especially a gastrointestinal viral or bacterial infection, or it may result from other types of inflammation. In both cases, bacteria may subsequently grow rapidly, causing the appendix to become inflamed and filled with pus. If not treated promptly, your appendix eventually may rupture.
Sometimes, the seepage of intestinal contents and infection may occur as an abscess, a walled-off area of infection. The abscess may be as small as a walnut or as large as a grapefruit. But no matter what its size, it requires surgery before the abscess itself perforates, causing peritonitis.
Appendicitis can cause a variety of symptoms that may change over time.
- Pain around your navel that often shifts to your lower-right abdomen. Young children, especially, may have appendicitis pain in different places.
In addition to pain, you may have one or more of the following symptoms:
- Nausea and sometimes vomiting
- Loss of appetite
- A low-grade fever that starts after other symptoms appear
The most serious complication of appendicitis is an infection of the lining of your abdominal cavity (peritonitis). This may occur if your appendix ruptures (perforates) and the contents of your intestines as well as the infection invade the peritoneal cavity. When this happens, your entire abdomen may become distended with gas and fluid and will likely feel tight and hard to the touch. You'll also have pain throughout your abdomen, but may not have the severe, localized pain of appendicitis. In addition, you may not be able to pass gas or have a bowel movement, and you may have a fever, thirst and a low urine output.
Peritonitis is a medical emergency. Even with prompt treatment, peritonitis can be extremely serious.
Children are more likely to have a ruptured appendix than adults are. They don't always have typical symptoms of appendicitis, and parents may delay getting treatment. For that reason, it's best not to take abdominal pain lightly. Even if you suspect a "stomach ache" isn't serious, call your doctor just to make sure.
If you have acute appendicitis, you'll need to have your appendix surgically removed (appendectomy). Your surgeon may perform traditional open surgery, using a single long abdominal incision, or choose laparoscopic surgery, which requires only a few small abdominal incisions.
In a laparoscopic procedure, your surgeon inserts a laparoscope a pencil-thin tube with its own lighting system and miniature video camera into your abdomen through a hollow instrument (cannula). The video camera then produces a magnified view of the inside of your abdomen on an outside video monitor. This allows your surgeon to see the surgery in detail. To remove your appendix, your surgeon uses tiny instruments inserted through several other small abdominal incisions.
Medical treatment for appendicitis can be attempted in select cases however need for emergency surgery can arise at any point of time in such management.
You will be given injectable antibiotics, analgesics and IV Fluids.
You will be started on orals after the bowel sounds normalize and gradually shifted to your normal diet.
