Appendicitis is an inflammation of the appendix of the caecum or blind gut. It is a very common disease that can occur at practically any age. Appendicitis is one of the conditions referred to as acute abdomen and requires immediate surgical treatment.
Large intestine anatomy
Caecum or blind gut is the initial part of the large intestine. It has a blind-ended tube at its end, which is called the vermiform appendix, or simply the appendix. The appendix is almost always located on the right side, a different position is rare. Its histological structure is the same as that of the large intestine and contains lymphatic tissue. It probably plays a role in regulation of immunity in humans, however, it is an organ that is with all likelihood expendable.
The origin of appendicitis
The causes or appendicitis are not known for the time being. It is assumed that inflammation occurs as a consequence of accumulation of stool in the blind-ended appendix. Under such conditions the drainage of blood from the tissue is impaired, accumulation of mucus takes place and bacteria can easily multiply and cause an inflammation. Another possibility is an excessive immune reaction to some harmful substance coming from the outside.
Symptoms of appendicitis
Appendicitis is one of the conditions referred to as acute abdomen. This means the illness comes about suddenly, practically from full health. It presents itself with abdominal pain, which is at first localized aroudn the navel and later moves to right lower abdomen. Elevated temperature, nausea and vomiting often accompany the condition. In such a case it is necessary to bring the patient into a hospital.
Diagnosing appendicitis isn’t easy as the above-mentioned symptoms can occur with many other diseases of the digestive tract, such as renal colic, gall bladder inflammation, a different kind of bowel inflammation or various gynecological problems in females. The correct diagnosis is especially difficult to make in pregnancy and such an undiscovered problem is especially severe. Diagnosing appendicitis starts with patient history and physical examination of the patient. Then follows blood work, which examines markers of inflammation, such as increased white blood cell numbers and other inflammatory changes. Out of the imaging methods, ultrasound of abdomen and the pelvic area is often performed. The examination isn’t painful, it is based on the ability of ultrasound to penetrate through tissues and reflect off of them and thus form an image. If even then the diagnosis isn’t clear, we proceed to a CT or computer tomography examination. This examination uses X-rays to create an image. A gynecological examination is recommended in females, to exclude an illness affecting the reproductive organs.
A patient with acute appendicitis needs to be hospitalized immediately. The doctor can choose between conservative and surgical treatment.
In case of conservative treatment the patient adopts a resting regime at the hospital. A strict diet is commenced and cool compresses are applied onto the stomach. Such treatment is appropriate in case of receding or mild appendicitis. It is said that in up to half of the cases the inflammation resolves itself. However, it is necessary to assume that the inflammation will appear repeatedly.
Surgical treatment is a much more common method of treatment while at the same time being radical. The route of access is either through a short incision above the inflamed part of the intestine or through so-called laparoscopy, when the surgeon makes a few almost negligible incisions through which he can insert special instruments into the abdominal cavity. The advantage is an excellent cosmetic outcome of the surgery.
Appendicitis is an illness that must be treated immediately when it occurs. Otherwise it may lead to complications which may even be deadly. The most frequent complication is a perforation - a rupture of the inflamed appendix, leading to so-called peritonitis - an inflammation of the peritoneum. An abscess may form as a complication, which is a demarcated cavity filled with pus. Adhesions may also form around the inflamed appendix.
Appendicitis is not a disease which can be especially prevented as its real cause is still not known. Genetic predisposition has not been proven, even though it is being considered. If someone suffers the above-mentioned symptoms the best solution is to visit a doctor without delay. The one thing that is sure is that after a successful removal of an appendix the same problem will never return.