Appendicitis
Appendix is a narrow blind tube like part & it's only open end communicates with
the(caecum) junction of small & large intestines.
This blind tube may get occlude due to enlarged lymphoid tissues.
Other causes of obstruction include, stool particle, tumours, parasites,low dietery
roughage with high intestinal pressure may cause functional obstruction.
Appendicitis can be divided in 2 types:
1) Acute:
a) Obstructive
b) Non-obstructive
2) Chronic
Acute Appendicitis: It is the most common abdominal surgical emergency. Patient
will presents with pain starts around umbilicus & after few hours to right lower
side of Abdomen,vomiting,fever, loss of appetite.
Chronic Appendicitis: In this patient gives history of recurrent attacks
of Acute Appendicitis, at interval of several months or more.
Treatment:
Acute Appendicitis
1) If there is no appendicular lump, then appendix should be removed.
2) If there is appendicular lump: Immediate 1st line of treatment followed by an
interval appendicectomy.
3) Patient is advised to take bed-rest, nothing should be given orally, intravenous
fluid administration with Antibiotics. A close watch is kept on patient, any deterioration
during this period calls for immediate operation.
4) Appendectomy: Emergency operation is mandatory in acute cases. In chronic cases
and after resolution of appendicular lump, elective surgery is mandatory after 6
weeks.
5) Laproscopic appendicectomy: It is new modality of the surgery. Surgery can be
performed with small incision, postoperative pain is less. Other condition can be
detected.
Complications:
1) Appendicular Lump: Most of the time treatment is
conservative and elective surgery after 6 weeks. If the patient is not responded
to conservative then surgery should be necessary.
2) Appendicular abscess.
3) Perforation
of appendix.
4) Gangrene appendix.
Chronic Appendicitis:
Well planned surgery (Appendicectomy)