Acute Appendicitis

June 09 22:59 2019 Print This Article

Appendicitis is a condition characterized by inflammation of the appendix . The appendix is a small, tube-like structure attached to the first part of the large intestine , also called the colon . It is located close to the ileocaecal junction. In the case of acute appendicitis, the vermiform appendix quickly becomes swollen and dies. Appendicitis may occur after a viral infection in the digestive tract or when the tube connecting the large intestine and appendix is blocked by trapped stool. The inflammation can cause infection, a blood clot, or rupture of the appendix. Because of the risk of rupture, appendicitis is considered an emergency.

Alternatively, particularly where perforation or gangrene occurs after 24 hours, the peritonitis may be localised, or the inflamed appendix may be surrounded by omentum to form an appendix mass or abscess. Symptoms of appendicitis include abdominal pain, fever, and vomiting. It is one of the top three conditions leading to pediatric abdominal surgery.

Acute appendicitis is considered to be a surgical illness and its treatment consists of removing the affected appendix. The surgical procedure used in acute appendicitis is called appendectomy and it needs to be performed as soon as possible, in order to prevent the development of complications. Although uncommon, appendicitis is very serious, and difficulty in diagnosing appendicitis in the emergency department makes appendicitis the 3rd leading cause of malpractice lawsuits.

Appendicitis, also called epityphilitis, is the infection or inflammation (severe irritation) of the tiniest part of the bowel – a worm-like out pouching of the bowel at the junction of the small and large intestine. The appendix is a small sac-like appendage of the large intestine that hangs down on the lower right side of the abdominal cavity. Appendicitis is frequently misdiagnosed, since it mimics other diseases. If untreated, an inflamed appendix can rupture, causing infection of the peritoneal cavity (the lining surrounding the abdominal organs) and even death. Appendicitis is the most common acute surgical emergency of the abdomen. Anyone can get appendicitis, but it occurs most often between the ages of 10 and 30.

Causes of Acute Appendicitis

Appendicitis is one of the most common causes of emergency abdominal surgery in the United States. Appendicitis usually occurs when the appendix becomes blocked by feces, a foreign object, or rarely, a tumor . The resulting inflammation can result in infection or rupture of the appendix. Also, bacterial or viral infections in the digestive tract can lead to swelling of lymph nodes, which squeeze the appendix and cause obstruction. This swelling of lymph nodes is known as lymphoid hyperplasia. Traumatic injury to the abdomen may lead to appendicitis in a small number of people. Genetics may be a factor in others. For example, appendicitis that runs in families may result from a genetic variant that predisposes a person to obstruction of the appendiceal lumen.

  • The inflammation can cause infection, a blood clot, or rupture of the appendix.
  • Infections that lead to swelling.
  • Appendicitis is one of the most common causes of emergency abdominal surgery in the United States.
  • Lymphoid hyperplasia is associated with a variety of inflammatory and infectious disorders including Crohn disease, gastroenteritis, amebiasis, respiratory infections, measles, and mononucleosis.

Signs and Symptoms of Acute Appendicitis

Sign and symptoms may include the following:

  • Diarrhea.
  • Nausea.
  • Constipation.
  • Fever.
  • Constipation or diarrhea.
  • Loss of appetite.
  • Chills and shaking.
  • Vomiting.
  • Abdominal swelling.
  • Inability to pass gas.

Treatment for Acute Appendicitis

The standard treatment of appendicitis is prompt surgical removal, sometimes accompanied by antibiotics. If the appendix ruptures into the abdomen, peritonitis (inflammation of the abdominal lining) and abscess formation may occur, increasing the risk of surgery. When the diagnosis is not clear from tests such as an ultrasound or CT scan, exploratory surgery is performed. If appendicitis is confirmed, either from the tests or the exploratory surgery, the appendix is removed in a procedure called an appendectomy.

  • Treatment for actinomycosis is long term, generally with up to one month of intravenous penicillin G, followed by weeks to months of penicillin taken by mouth.
  • Antibiotics are often given intravenously to help kill remaining bacteria and thus reduce the incidence of infectious complication in the abdomen or wound.
  • Appendicitis is generally treated by surgical removal of the appendix
  • The EMS provider must gather accurate “QRST” data including estimated fluid intake and loss, the child’s weight gain or loss, and home remedies and interventions.
  • If the operation reveals that the appendix is normal, the surgeon will remove the appendix and explore the rest of the abdomen for other causes of your pain.