Watch video about laparoscopic appendectomy surgery here for FREE! You'll see how doctors do with our appendix!.Review all aspect of appendicitis including symptoms, sign, investigation,treatment and surgery
Watch video about laparoscopic appendectomy surgery here for FREE! You'll see how doctors do with our appendix!.Summary of Appendicitis Disease
Summary of Appendicitis Disease
The appendix is a closed, narrow tube up to several centimeters in length that attaches to the cecum (the first part of the colon) like a worm. (The anatomical name for the plant, ie vermiform, worm-like appendage.) The inner lining of the plant produces a small amount of mucus is flowing through the open center of the plant and in the appendix. The wall of the appendix contains lymphatic tissue that is part of the immune system to produce antibodies. As theRest of the colon, the wall of the annex includes a layer of muscles, but the muscle is poorly developed.
Appendicitis Appendicitis means inflammation of the plant. It is thought that appendicitis begins when the opening is blocked from the appendix in the cecum. The blockage may be caused by accumulation of mucus within the appendix or to stool that enters the plant from the appendix. The mucus or stool hardens, as is rock and block the opening. This rock isfecalith called (literally, a rock of stool). At other times, the lymphatic tissue to swell and block the attachment can the plant. After the blockage occurs, bacteria that are normally found in the annex to begin (infect) penetrate the wall of the plant. The body reacts to the invasion of mounting an attack on the bacteria, as an attack inflammation. An alternative theory for the cause of appendicitis is followed by a first fraction of the plant by the spread of bacteria outsideAppendix .. The cause of such a rupture is unclear, but it can lead to changes in the lymphatic tissue, inflammation, for example, that there will be the wall of the plant cover line.)
If the inflammation and the spread of infection through the wall of the appendix, the plant can be broken. After breaking an infection can spread into the abdomen, but usually it is a small neighborhood of the plant is limited (formation of a peri-appendiceal abscess).
Sometimes the body is successfulcontaining ( “healing”) the appendicitis without surgical treatment, if not spread the infection and accompanying inflammation in the stomach. May disappear, the inflammation, pain and symptoms. This applies especially in elderly patients and used for antibiotics. The patient can then come to the doctor long after the episode of appendicitis with a lump or a tumor in the right lower abdomen, the result of scarring that occurs during healing. This package could increaseSuspicion of cancer.
Symptoms
The main symptom of appendicitis abdominal pain. The pain is at first diffuse and poorly localized, which is not confined to one location. (Bad localized pain is typical when a problem is confined to the small intestine and large intestine, including the annex). The pain is so difficult to grasp when asked to enter the field of pain point that most people of the city pain with a circular motion of her hand around the central part of theirStomach. A second, common, early symptom of appendicitis is loss of appetite, nausea and even progress to vomiting. Nausea and vomiting can also occur later by intestinal obstruction.
As an appendix inflammation increases, it extends through the system known to its outer shell and then to the lining of the stomach, peritoneum, a thin membrane. Once ignited, the peritoneum, the pain changes and then clearly localized to a small area. In general, this areabetween the front of the right hip bone and the navel. The exact point is named after Dr. Charles McBurney – McBurney’s point. If the system ruptures and infection spreads into the abdomen, the achiness rekindled as the entire lining of the stomach is.
Diagnosis
The diagnosis of appendicitis begins with a thorough history and physical examination. Often the patients have an elevated temperature, and it is usually in moderate to severe tendernessright lower abdomen when the doctor pushes there. If inflammation has spread to the peritoneum, there is often pain on pressure. Pressure pain is pain that is worse when the doctor quickly release his hand after gently pressing on the abdomen over the area of tenderness.
Number of white blood cells
The number of white blood cells in the blood is increased in general with an infection. Early appendicitis, before infection begins, it may be normal, but most often it is at least oneslight increase also early. Unfortunately, appendicitis is not the only condition that causes elevated white blood cell count. Almost any infection or inflammation, this can lead to unusually high count. Therefore, an increased number of white blood cells alone can not be used as a sign of appendicitis.
Urinalysis
Urinalysis is a microscopic examination of the urine that detects red blood cells, white blood cells and bacteria in the urine. Urinalysis usually is abnormal when itInflammation or stones in the kidneys or bladder. The urinalysis is abnormal with appendicitis because the facility is located near the urethra and bladder. If the inflammation of appendicitis is large enough, it can be to the ureters and bladder that is abnormal urinalysis. Most patients with appendicitis, however, have a normal urinalysis. Therefore, a normal urinalysis suggests appendicitis more than a urinary tract problem.
Abdominal X-Ray
A normal x-ray can detect thefecalith (the hardened and calcified, pea-sized piece of stool blocking the opening Appendix) that the cause may be appendicitis. This is especially true in children.
Ultrasound
An ultrasound scan is a painless procedure that uses sound waves to identify organs in the body. Ultrasound can identify an expanded facility or an abscess. Nevertheless, during appendicitis, the system can be observed in only 50% of patients. Therefore, a look at an ultrasound system is notAppendicitis ruled out. Ultrasound is also useful for women because it ensures the presence of conditions that can, the ovaries, fallopian tubes and uterus that can mimic appendicitis are excluded.
Barium Enema
A barium enema is an x-ray test where liquid barium is introduced into the colon from the anus to fill the bowel. This test may from time to time, show an impression on the colon in the vicinity of the plant where the inflammation from the adjacent meets inflammation of the colon. Barium alsoexclude other intestinal problems that simulate appendicitis, such as Crohn’s disease.
Computed tomography (CT)
For patients who are not pregnant, a CT scan of the area of the plant is in diagnosing appendicitis and peri-appendiceal abscesses as well as the exclusion of other diseases in the abdomen and pelvis, which mimic appendicitis useful.
Laparoscopy
Laparoscopy is a surgical procedure, introduced in which a small fiberoptic tube with a camera into the abdomen througha small hole made in the abdominal wall. Laparoscopy allows a direct view of the plant, and other abdominal and pelvic organs. If appendicitis is found, the inflamed appendix with the laparascope be removed. The disadvantage of laparoscopy compared to ultrasound and CT is that it requires a general anesthetic.
There is no test that will diagnose appendicitis with certainty. Therefore, the approach to suspected appendicitis may include a period of observation, testsmentioned, or surgery.
Treatment
Once the diagnosis of appendicitis is an appendectomy operation is usually performed. Antibiotics started before surgery and almost always as fast as a suspected appendicitis.
There is a small group of patients in whom the inflammation and infection of appendicitis remain mild and localized to a small area. The body is able to not only contain the inflammation and infection, but to solve it as well. These patients are usually not very ill, andImprove during several days of observation. This type of appendicitis is referred to as “confined appendicitis” and may be treated with antibiotics alone. The plant can not or will not be removed at a later date.
Occasionally, a person can not see their doctor until appendicitis with rupture has been present for many days or even weeks. Formed in this situation, usually has an abscess, and perforation of the appendix have signed on. If the abscess is small, can initially be treatedwith antibiotics, but the abscess usually requires drainage. A drain (a small plastic or rubber tube) usually is inserted through the skin and into the abscess using an ultrasound or CT scan that can determine the exact location of the abscess. The drain allows pus from the abscess to flow from the body. The plant can be removed several weeks or months after the abscess has resolved. This will is called an interval appendectomy and done to prevent a second attackAppendicitis.
Surgical Intervention: Appendectomy
During an appendectomy, an average of two to three centimeters in length is made through the skin and the layers of the abdominal wall in the area of the plant. The surgeon enters the abdomen and looks for the plant, which is usually in the right lower abdomen. After examining the vicinity of the plant to be sure that no additional problem is present, is removed the plant. This is done by the liberation of the plant its mesentericAttachment to the stomach and colon, cutting the plant from the colon and sewing over the hole in the colon. If an abscess is present, the pus can be drained with drains that the transfer of abscesses and out through the skin. The abdominal incision is then closed.
Newer techniques for the removal of the facility is through the use of the laparoscope. The laparoscopy is attached to a thin, telescope, video camera, which the surgeon can inspect the inside of the abdomen through a small incision toWound (instead of a larger incision). If appendicitis is found, the facility with special instruments that can be passed into the abdomen, as well as laparoscopy are removed through small puncture wounds. The advantages of the laparoscopic technique are less postoperative pain (since much of the post-operative pain comes from incisions) and a faster return to normal activities. Another advantage of laparoscopy is that it allows the surgeon into the abdomen to look intoclear diagnosis in cases where the diagnosis of appendicitis is in doubt. For example, laparoscopy is especially helpful during menstruation women whose ovarian cysts can mimic a fracture of appendicitis.
If the appendix is not perforated (perforated) at the time of surgery, the patient usually house is from the hospital after the operation in sending one or two days. Patients whose facility with perforated are sicker than patients without perforation, and their hospital stay is often prolonged(four to seven days), especially if peritonitis occurs. Intravenous antibiotics in the hospital given to fight infection and assist in resolving any abscess.
Occasionally, the surgeon can find a normal-appearing facility and no other cause for the problem of the patient. In this situation, the surgeon can remove the plant. The reasoning in these cases is that it is better to remove miss a normal-appearing as an investment and not to treat appropriately an early or mild case ofAppendicitis.
Appendix
The appendix is a closed, narrow tube up to several centimeters in length that attaches to the cecum (the first part of the colon) like a worm. (The anatomical name for the plant, ie vermiform, worm-like appendage.) The inner lining of the plant produces a small amount of mucus is flowing through the open center of the plant and in the appendix. The wall of the appendix contains lymphatic tissue that is part of the immune system to produce antibodies. As theRest of the colon, the wall of the annex includes a layer of muscles, but the muscle is poorly developed.
Appendicitis Appendicitis means inflammation of the plant. It is thought that appendicitis begins when the opening is blocked from the appendix in the cecum. The blockage may be caused by accumulation of mucus within the appendix or to stool that enters the plant from the appendix. The mucus or stool hardens, as is rock and block the opening. This rock isfecalith called (literally, a rock of stool). At other times, the lymphatic tissue to swell and block the attachment can the plant. After the blockage occurs, bacteria that are normally found in the annex to begin (infect) penetrate the wall of the plant. The body reacts to the invasion of mounting an attack on the bacteria, as an attack inflammation. An alternative theory for the cause of appendicitis is followed by a first fraction of the plant by the spread of bacteria outsideAppendix .. The cause of such a rupture is unclear, but it can lead to changes in the lymphatic tissue, inflammation, for example, that there will be the wall of the plant cover line.)
If the inflammation and the spread of infection through the wall of the appendix, the plant can be broken. After breaking an infection can spread into the abdomen, but usually it is a small neighborhood of the plant is limited (formation of a peri-appendiceal abscess).
Sometimes the body is successfulcontaining ( “healing”) the appendicitis without surgical treatment, if not spread the infection and accompanying inflammation in the stomach. May disappear, the inflammation, pain and symptoms. This applies especially in elderly patients and used for antibiotics. The patient can then come to the doctor long after the episode of appendicitis with a lump or a tumor in the right lower abdomen, the result of scarring that occurs during healing. This package could increaseSuspicion of cancer.
Symptoms
The main symptom of appendicitis abdominal pain. The pain is at first diffuse and poorly localized, which is not confined to one location. (Bad localized pain is typical when a problem is confined to the small intestine and large intestine, including the annex). The pain is so difficult to grasp when asked to enter the field of pain point that most people of the city pain with a circular motion of her hand around the central part of theirStomach. A second, common, early symptom of appendicitis is loss of appetite, nausea and even progress to vomiting. Nausea and vomiting can also occur later by intestinal obstruction.
As an appendix inflammation increases, it extends through the system known to its outer shell and then to the lining of the stomach, peritoneum, a thin membrane. Once ignited, the peritoneum, the pain changes and then clearly localized to a small area. In general, this areabetween the front of the right hip bone and the navel. The exact point is named after Dr. Charles McBurney – McBurney’s point. If the system ruptures and infection spreads into the abdomen, the achiness rekindled as the entire lining of the stomach is.
Diagnosis
The diagnosis of appendicitis begins with a thorough history and physical examination. Often the patients have an elevated temperature, and it is usually in moderate to severe tendernessright lower abdomen when the doctor pushes there. If inflammation has spread to the peritoneum, there is often pain on pressure. Pressure pain is pain that is worse when the doctor quickly release his hand after gently pressing on the abdomen over the area of tenderness.
Number of white blood cells
The number of white blood cells in the blood is increased in general with an infection. Early appendicitis, before infection begins, it may be normal, but most often it is at least oneslight increase also early. Unfortunately, appendicitis is not the only condition that causes elevated white blood cell count. Almost any infection or inflammation, this can lead to unusually high count. Therefore, an increased number of white blood cells alone can not be used as a sign of appendicitis.
Urinalysis
Urinalysis is a microscopic examination of the urine that detects red blood cells, white blood cells and bacteria in the urine. Urinalysis usually is abnormal when itInflammation or stones in the kidneys or bladder. The urinalysis is abnormal with appendicitis because the facility is located near the urethra and bladder. If the inflammation of appendicitis is large enough, it can be to the ureters and bladder that is abnormal urinalysis. Most patients with appendicitis, however, have a normal urinalysis. Therefore, a normal urinalysis suggests appendicitis more than a urinary tract problem.
Abdominal X-Ray
A normal x-ray can detect thefecalith (the hardened and calcified, pea-sized piece of stool blocking the opening Appendix) that the cause may be appendicitis. This is especially true in children.
Ultrasound
An ultrasound scan is a painless procedure that uses sound waves to identify organs in the body. Ultrasound can identify an expanded facility or an abscess. Nevertheless, during appendicitis, the system can be observed in only 50% of patients. Therefore, a look at an ultrasound system is notAppendicitis ruled out. Ultrasound is also useful for women because it ensures the presence of conditions that can, the ovaries, fallopian tubes and uterus that can mimic appendicitis are excluded.
Barium Enema
A barium enema is an x-ray test where liquid barium is introduced into the colon from the anus to fill the bowel. This test may from time to time, show an impression on the colon in the vicinity of the plant where the inflammation from the adjacent meets inflammation of the colon. Barium alsoexclude other intestinal problems that simulate appendicitis, such as Crohn’s disease.
Computed tomography (CT)
For patients who are not pregnant, a CT scan of the area of the plant is in diagnosing appendicitis and peri-appendiceal abscesses as well as the exclusion of other diseases in the abdomen and pelvis, which mimic appendicitis useful.
Laparoscopy
Laparoscopy is a surgical procedure, introduced in which a small fiberoptic tube with a camera into the abdomen througha small hole made in the abdominal wall. Laparoscopy allows a direct view of the plant, and other abdominal and pelvic organs. If appendicitis is found, the inflamed appendix with the laparascope be removed. The disadvantage of laparoscopy compared to ultrasound and CT is that it requires a general anesthetic.
There is no test that will diagnose appendicitis with certainty. Therefore, the approach to suspected appendicitis may include a period of observation, testsmentioned, or surgery.
Treatment
Once the diagnosis of appendicitis is an appendectomy operation is usually performed. Antibiotics started before surgery and almost always as fast as a suspected appendicitis.
There is a small group of patients in whom the inflammation and infection of appendicitis remain mild and localized to a small area. The body is able to not only contain the inflammation and infection, but to solve it as well. These patients are usually not very ill, andImprove during several days of observation. This type of appendicitis is referred to as “confined appendicitis” and may be treated with antibiotics alone. The plant can not or will not be removed at a later date.
Occasionally, a person can not see their doctor until appendicitis with rupture has been present for many days or even weeks. Formed in this situation, usually has an abscess, and perforation of the appendix have signed on. If the abscess is small, can initially be treatedwith antibiotics, but the abscess usually requires drainage. A drain (a small plastic or rubber tube) usually is inserted through the skin and into the abscess using an ultrasound or CT scan that can determine the exact location of the abscess. The drain allows pus from the abscess to flow from the body. The plant can be removed several weeks or months after the abscess has resolved. This will is called an interval appendectomy and done to prevent a second attackAppendicitis.
Surgical Intervention: Appendectomy
During an appendectomy, an average of two to three centimeters in length is made through the skin and the layers of the abdominal wall in the area of the plant. The surgeon enters the abdomen and looks for the plant, which is usually in the right lower abdomen. After examining the vicinity of the plant to be sure that no additional problem is present, is removed the plant. This is done by the liberation of the plant its mesentericAttachment to the stomach and colon, cutting the plant from the colon and sewing over the hole in the colon. If an abscess is present, the pus can be drained with drains that the transfer of abscesses and out through the skin. The abdominal incision is then closed.
Newer techniques for the removal of the facility is through the use of the laparoscope. The laparoscopy is attached to a thin, telescope, video camera, which the surgeon can inspect the inside of the abdomen through a small incision toWound (instead of a larger incision). If appendicitis is found, the facility with special instruments that can be passed into the abdomen, as well as laparoscopy are removed through small puncture wounds. The advantages of the laparoscopic technique are less postoperative pain (since much of the post-operative pain comes from incisions) and a faster return to normal activities. Another advantage of laparoscopy is that it allows the surgeon into the abdomen to look intoclear diagnosis in cases where the diagnosis of appendicitis is in doubt. For example, laparoscopy is especially helpful during menstruation women whose ovarian cysts can mimic a fracture of appendicitis.
If the appendix is not perforated (perforated) at the time of surgery, the patient usually house is from the hospital after the operation in sending one or two days. Patients whose facility with perforated are sicker than patients without perforation, and their hospital stay is often prolonged(four to seven days), especially if peritonitis occurs. Intravenous antibiotics in the hospital given to fight infection and assist in resolving any abscess.
Occasionally, the surgeon can find a normal-appearing facility and no other cause for the problem of the patient. In this situation, the surgeon can remove the plant. The reasoning in these cases is that it is better to remove miss a normal-appearing as an investment and not to treat appropriately an early or mild case ofAppendicitis.
