Appendicitis is the most common surgical emergency of the abdomen. It affects about 10% of the population. The incidence of appendicitis is about 1 in 500 persons every year. Appendicitis means inflammation of the appendix. It is thought that appendicitis begins when the opening from the appendix into the cecum becomes blocked. The blockage may be due to a build-up of thick mucus within the appendix or to stool that enters the appendix from the cecum. The mucus or stool hardens, becomes rock-like, and blocks the opening. This rock is called a fecalith (literally, a rock of stool).
Cause Of Appendicitis
The cause of appendicitis cannot be attributed to any one single factor. Fecal material is thought to be one possible obstructing object. Bacteria, viruses, fungi, and parasites can be responsible agents of an infection that leads to swelling of the tissues of the appendix wall, including Yersinia species, adenovirus, cytomegalovirus, actinomycosis, Mycobacteria species, Histoplasma species, Schistosoma species, pinworms, and Strongyloides stercoralis. Also, swelling of the tissue from inflammatory bowel diseases such as Crohn’s disease may cause appendicitis. It appears that appendicitis is not hereditary or transmittable from person to person.
Symptoms Of Appendicitis
Pain in the abdomen, first around the belly button and then in the lower right area
Loss of appetite
Constipation or diarrhea
Inability to pass gas
Low fever, which begins after other symptoms
Uncomforting feeling in the abdomen
Pain in the center of abdomen
Feeling that a bowel movement will relieve the discomfort
The treatment requires surgical removal of the appendix. The conventional method is the removal of the appendix by an open laparotomy. The current treatment followed is ligation and electrocauterisation. For patients who have signs of peritonitis a peritoneal lavage with saline is done. The use of drains is controversial.
The recent method of surgery adopted is the Laparoscopic appendectomy. This procedure makes use of a laparoscope for the removal of the appendix. The advantages are shorter hospital stay, decrease in the incidence of postoperative infection, shorter convalescent period and greater cosmetic acceptance. The disadvantages are longer operating time (about 20 minutes).