The appendix is a small, worm-like protrusion from the large intestine. It’s associated with the maintenance of the gut flora and is the home of billions of bacteria. However, it’s considered to be a vestigial evolutionary remnant in the human body, alongside wisdom teeth and the third eyelid’. Appendicitis is an inflammation of this organ which can occur as a result of a blockage in the appendix. The swelling and the increase in pressure can lead to restriction of blood flow and necrosis. If left untreated, appendicitis can result in the bursting of the appendix which is considered a medical emergency. This is because the bacterial leakage can infect the peritoneum (the abdominal lining covering the digestive tract) and lead to sepsis and eventually, death.
Usually, the first stages of appendicitis are asymptomatic. However, as the appendix swells, rapid onset of sharp pain appears in the lower abdomen. Other symptoms include nausea, vomiting, and decreased appetite. Some patients describe the pain as being repeatedly’ stabbed in the gut.’ The severity of the symptoms varies according to the severity of the inflammation. Due to the probability for sepsis, appendicitis is considered a medical emergency that requires immediate medical attention
There are methods of diagnosing appendicitis – clinical examination, ultrasound, computed tomography, magnetic resonance imaging and laparoscopy. There are several clinical signs that indicate the presence of appendicitis. Among others, these include Aure-Rozanova’s sign, Hamburger sign, Kosher’s sign, Psoas sign, Rovsing’s sign and Rosenstein’s sign.
In less extreme cases, where the chance of bursting is minimal, antibiotics can successfully manage the condition. However, about a quarter of the cases had incidence of recurring appendicitis – requiring surgical removal of the appendix (appendectomy)
Appendectomy is the preferred course of action in dealing with appendicitis. It involves the surgical removal of the appendix and any surrounding affected tissue under general anesthesia. There are two types of appendectomy currently performed in most general hospitals – open appendectomy and laparoscopic appendectomy. Open appendectomy involves a large incision in the abdominal area from which the appendix is identified, accessed and removed. Moreover, after the successful removal of the appendix, the wound is carefully stitched up, and the patient is monitored for several days.
Laparoscopic appendectomy is less invasive than open appendectomy and requires less recovery time. It’s also associated with lower risk of developing postoperative complications in the patient. In this surgical method, three small incisions are made through which a laparoscope and other surgical instruments are inserted into the abdominal cavity. The laparoscope helps the surgeon identify the appendix. The appendix is then removed and cauterized.
Depending on the severity of the appendicitis, patients remain from two to seven days in postoperative hospital care. Those who suffered a rupture in the appendix usually require more time to recover, as well as an increased risk of developing post-op complications. Appendectomy is considered a safe surgical procedure from which the patients easily recover. They return to a normal diet within two days of the operation. Additionally, they are required to move regularly and sit upright to promote faster healing. The removal of the appendix doesn’t cause any deficiency or decrease in quality of life.
Appendicitis is a medical emergency which usually requires the surgical removal of the appendix. Appendectomy is one of the most common surgical procedure, with more than 280.000 cases annually.