Appendicitis
Appendicitis is an inflammation of the vermiform appendix caused by obstruction of the intestinal lumen from infection, stricture, fecal mass, foreign body or tumour.
Causes
1. Obstruction of the appendix causes accumulation of mucus and swelling leading to appendicitis.
2. Obstruction occurs due to the accumulation of faecal matter, enlargement of lymphoid follicles, intestinal worms, and tumours.
Pathophysiology
Obstruction of the intestinal lumen is followed by edema, infection and ischemia of the appendix. As intraluminal tension develops, necrosis and perforation usually occur.
Signs and Symptoms
The typical symptoms of acute appendicitis are
1. Severe pain in the right side of the lower abdomen.
2. Rebound tenderness at McBurney’s point.
3. Anoxia.
4. Low-grade fever.
5. Nausea and vomiting.
6. Constipation or diarrhoea occurs.
Diagnosis
1. Physical examination. Rebound tenderness at Mc Burney’s point.
2. Laboratory test: complete blood count will show
* Leucocytosis
* Urinalysis
3. Abdominal X-ray to visualize shadow consistent with fecalith in appendix.
4. U.S.G. Abdomen
Management
Surgery:
The standard Management for appendicitis is surgery that involeves removal of the appendix. The procedure is called appendectomy that can be done in two methods:
Laparotomy – a single incision is made to remove the appendix
Laparoscopic appendectomy – several small incisions are made using special surgical tools to remove the appendix. The advantage of this surgery is fast recovery
Complication
* Peritonitis
* Perforation
* Abscess formation
