Medical Blog

The appendix is an appendix of the cecum, at the bottom of the stomach in the transition from the small to the large intestine. The appendix is between 2 and 20 cm long, about as thick as a pencil and consists mainly of lymphoid tissue. The function of the appendix is not clear, perhaps that function in the course of our evolution lost. Possibly plays a role in the development of our immune system.

The appendix can become inflamed - we can speak of an appendicitis - and he should be removed. This disease affects approximately 7% of the population. It affects all ages, but especially between 5 and 24 years, with a peak around 6 years.

Symptoms

The symptoms of an inflamed appendix can vary widely and are not always clearly recognizable. Careful screening is important, however, especially in an acute appendicitis that threatens to burst open (perforate). Approximately 5 holes at 100 run is fatal. Fortunately they are rare.
Sometimes one suspects appendicitis but that is not there and people are needlessly operated. This is also an unfortunate situation. Each operation takes is a small but real risk.
The problem is that people with appendicitis early intervention, but at the same time that people should avoid unnecessary under the knife pass.

• The inflammation causes severe abdominal pain, initially near the umbilicus, later in the lower right abdomen. Sometimes the appendix is located at a new place and the pain may emerge elsewhere.
• Other symptoms include nausea, sometimes vomiting, mild fever and diarrhea. After several hours, pain also occurs when touching the abdomen.

If the doctor suspects appendicitis, he will exhaust other possible causes of abdominal pain (pregnancy, intestinal infection ...) and try to exclude any conduct additional tests, including:
• Blood tests to determine whether an infection is
• Urinalysis for other reasons (pregnancy, bladder infection, etc.) to exclude
• An ultrasound: this is a safe technique, with one very focused on the location of the pain can investigate. An ultrasound is difficult for overweight people or when there is a lot of intestinal gas.
• X-rays: is often performed but is usually unnecessary if an ultrasound is done
• CT scan: only indicated if ultrasound is inconclusive
• A laparoscopy: This procedure may be viewing tube through a small incision across the abdomen inspected. This is especially interesting for the study of women because some complaints unrelated to an alleged to have appendicitis, but the result of such disorders of the ovaries, uterus or other pelvic problems.

Especially in children in whom the disease can progress very rapidly in the elderly whose symptoms are less distinct, and in pregnant women, the diagnosis may be difficult.

Treatment

Once it is established that the appendix is inflamed, it must be surgically removed. This should usually soon after the emergence of the first symptoms occur, especially in children, to avoid the appendix wall breaks open and their contents into the abdominal cavity chain. This can be a life-threatening inflammation of the peritoneum cause.
Depending on the severity of inflammation, the surgeon operating a classic look or a surgery. After four to five days one can normally leave the hospital. The recovery can take up to several weeks.

Operation

At surgery, the cecum searched, cleared and removed. The operation itself can, through a small incision in the right lower abdomen or through an exploratory operation to be performed. When in doubt, also a cut in the middle of the abdomen are used. It may be a possible alternative cause of pain are detected and treated. Which method will be chosen depends on many factors including the severity of inflammation, the preference of the surgeon, et cetera.

However, sometimes around the inflamed appendix has a lot of adhesions and bowel caused by hedging. This is sometimes the examination as a resistance in the right lower abdomen to feel. This is called a appendiculair infiltrate (this usually occurs after a few days ill and is a natural reaction of the body). In such case, the inflammatory infiltrate and cool down and "relax" prior to surgery if necessary to proceed (after several weeks of bed rest, antibiotics and possibly gradual recovery for six to eight weeks, and decreased resistance). This gradually relax and restore the appendix and the infiltrate may be followed by the BSE at certain times to determine and leucocyte count. This will decrease. Also at different times of the stomach examined.

Possible complications

The development of complications often depends on the severity of inflammation. General complications such as wound infection and bleeding are possible. Sometimes there is delayed healing and delayed recovery of bowel movements. In severe inflammation and abdominal fluid, antibiotics are administered. In wound abscesses, the skin wound may open again, so good drainage of the pus is possible. The recovery usually takes longer. Also some weeks after discharge a short period cramping pain be felt. This is sometimes caused by adhesions in the abdomen through which the bowel movements may increase. If this pain, the doctor will be alerted. Sometimes there after an operation for appendicitis abscess in the abdomen. In some cases, disappears through the anus, occasionally must be treated surgically or can be punctured under imaging control.

After surgery

After surgery, the patient (e) an infusion for fluid and drug administration. The bowel movements are gradually resumed and the power is gradually expanded. In general, you can take a few days returned to normal washing and showering. After four to five days the patient (e) are usually released, often over the normal diet possible again.

After about seven days, the stitches will be removed. With true acute inflammation with pus or free fluid in the abdomen is sometimes left open skin wound. This healing takes slightly longer than in general.

Recovery usually takes a couple of weeks. After that the normal work and the work resumed.