Overview:
- appendix is a small tubular organ that originates from cecum directly after ileocecal junction
- it varies in length from person to person (usually 6-10cm)
- it has a role in strengthening the immune system in childhood
- Appendicitis leads to a blockage in its small Lumen mainly, which leads to the appearance of rapidly progressing symptoms
Etiology:
- Inflammation in appendix occurs as part of inflammation in the intestine and edema occurs in the wall of the appendix , or due to blockage of the lumen of the appendix (as in the case of fecal stones)
- Appendicitis may occur due to the presence of a tumor in it
Symptoms:
- fatigue
- Mild fever
- Abdominal pain in the lower right quadrant increases with coughing and walking
- Abdominal pain around navel radiates to the lower right abdomen
- Nausea and vomiting
- Appetite loss
- bloating
- Constipation or diarrhea may occur
- rupture of the congested appendix may lead to the formation of a localized phlegmon (a purulent collection surrounding by intestine and mesentery)
or may lead to generalized peritonitis, a life-threatening condition
- appendix is usually located in lower right quadrant of the abdomen, but sometimes it may extend into the pelvis causing pelvic symptoms, or it is located retroperitoneum, causing in an ambiguous clinical view that requires careful examination and further investigation
Causes:
With the blockage of the lumens, germs multiply rapidly, leading to inflammation of the appendix and its congestion
Pus may form inside and may burst if the patient does not receive proper medical treatment quickly
Risk factors to appendicitis:
- Causes of edema in the wall of appendix such as enteritis and inflammatory bowel disease
- Causes that lead to blockage of appendix lumen such as some swallowed fruit seeds (grapes)
Diagnosis:
- Careful clinical examination
- Laboratory test: to detect any infection, rule out the presence of urinary inflammation or kidney stones
- Radiology investigations: ultrasound and CT
Treatment:
- Treatment of the inflamed appendix is laparoscopic appendectomy
abdomen cavity is insufflated with gas (CO2) and the scope and surgical instruments are inserted through small holes in the abdominal wall
Inflamed appendix is released away from its mesentery
Appendix is taken out via on of our small ports
- Treatment of localized abscess which caused by perforation of appendix is drainage of abscess followed by appendectomy later
