Appendicitis
Appendicitis occurs when the appendix becomes inflamed. It most commonly occurs in children who are 8 – 18 years old but can occur at any age. The underlying problem is obstruction of the appendix lumen (opening) by either a faecolith (hardened stool) or glandular enlargement. It may also rarely be caused by intestinal worms and tumours.
What are the symptoms of appendicitis?
Appendicitis classically presents with colicky (cramping) peri-umbilical pain followed by nausea. Low-grade fever and loss of appetite can also be present. Within 24 hrs, the pain then localizes to the right lower aspect of the abdomen. Other appendicitis symptoms may include:
- Diarrhoea
- Indigestion
- Pain around your belly button or in your upper abdomen
- Abdominal distension
- Vomiting
Seek medical attention if you are experiencing tenderness on the right side of your abdomen, which may be accompanied by any of the other appendicitis symptoms. Diagnosing appendicitis can be easy in patients with classic history and the typical clinical finding of severe tenderness (peritonism) in the right lower quadrant. However, when there is any doubt as to the diagnosis further imaging in the form of an ultrasound or CT scan may be necessary.
How is appendicitis treated?
Once the diagnosis has been confirmed, treatment should occur promptly in order to avoid the complication of appendix perforation with subsequent generalized peritonitis or abscess formation. Dr Cooper will recommend that you start antibiotics immediately and be taken to theatre on urgent basis for removal of the appendix. In most cases, the surgeon will remove the appendix through a minimally invasive/laparoscopic procedure called an appendectomy. This approach has the advantages of:
- Smaller wounds with less pain and quicker healing
- Easier to diagnose other pathology should the appendix be normal.
- Better ability to wash out the whole abdomen in the case of generalized peritonitis.
During the laparoscopic procedure, Dr Cooper will make three small incisions on the lower part of the abdomen near the location of the appendix to facilitate the placement of 3 ports. He will then insert a thin telescopic lens/camera, called a laparoscope, inside the port to help him see the inside of the abdomen. Dr Cooper will then remove the appendix. In the unlikely event that a normal appendix is found at the time of the surgery the rest of the abdomen will be thoroughly inspected to exclude other causes for the patient’s symptoms. The appendix would mostly still removed in order to avoid future diagnostic uncertainty.