Appendicitis

 

Introduction

Appendicitis is called inflamed and swollen appendix. The appendix is a small finger-shaped pouch on the right side of the abdomen. Its size is different from 5 cm to 35 cm, on average 9 cm in adults, connected to the colon and regularly is full and empty with foods.  

The appendix is a small, tube-like organ attached to the first part of the large intestine. It is located in the lower right part of the abdomen. It has no known function. A blockage inside of the appendix causes appendicitis. The blockage leads to increased pressure, problems with blood flow, and inflammation. If the blockage is not treated, the appendix can burst and spread infection into the abdomen. This causes a condition called peritonitis.

Appendicitis is a medical emergency. Treatment almost always involves removing the appendix. Anyone can get appendicitis, but it is more common among people 10 to 30 years old.

Symptoms

 

 - Low-grade fever and sometimes nausea and vomiting. Loss of appetite is common too.

 - Dull pain near the navel or the upper abdomen that often shift to your lower right abdomen (Sharp, obvious and local pain)

 - Intense and permanent pain begins if appendicitis is broken. Flatulence is formed and patient status become worse. Constipation or diarrhea may appear in intense appendicitis. Do not eat, drink, or use any pain remedies, antacids, laxatives, or heating pads, which can cause an inflamed appendix to rupture. Inflamed appendicitis may be ripped up if use laxative. Diarrhea may cause if appendicitis is in hip, may cause flank pain if it is in the back of colon and also if it is in lower liver, it may mistake with gallbladder.

Complications:

Tearing the appendix that is specified by following symptoms:

• Decreasing sudden pain after appendix tearing and inflamed peritonitis which specified by:
• Uncontrolled vomiting
• Swelling, tight and stiff of the abdomen
• Intense sickly situation of patient which tends to lie down to flank and knees bent
• Rapid heartbeat, shortness of breathwith rapid breathing, reducing blood pressure
• Ague and average of 38.5 degree centigrade of temperature
• Dizziness/feelings of faintness
• Irritability, Restlessness and anxiety
• Decreasing colon voice

Diagnostic tests:

• Blood test to see if your body is fighting infection
• CT scans or ultrasound

Different kind of Treatment

• Prepare for surgery
• Refrain from eating or drinking at least 8 hours before surgery
• Adding serum
• Putting a tube in stomach through nose
• Putting on bed in terms of half sitting
• Drugs

Different types of antibiotics

• Surgery

Performing surgery whiting 24 to 48 hours after beginning symptoms until stable situation. In general, we have two kind of appendectomy: Open surgery and Keyhole surgery (laparoscopy)

• Open Surgery

During an open appendectomy, a surgeon makes one incision in the lower right side of your abdomen. Your appendix is removed and the wound is closed with stiches. This procedure allows your doctor to clean the abdominal cavity if your appendix has burst.

Your doctor may choose an open appendectomy if your appendix has ruptured and the infection has spread to other organs. It’s also the preferred option for people who have had abdominal surgery in the past.

• Keyhole Surgery

During a laparoscopic appendectomy, a surgeon accesses the appendix through a few small incisions in your abdomen. A small, narrow tube called a cannula will then be inserted. The cannula is used to inflate your abdomen with carbon dioxide gas. This gas allows the surgeon to see your appendix more clearly.

Once the abdomen is inflated, an instrument called a laparoscope will be inserted through the incision. The laparoscope is a long, thin tube with a high-intensity light and a high-resolution camera at the front. The camera will display the images on a screen, allowing the surgeon to see inside your abdomen and guide the instruments. When the appendix is found, it will be tied off with stiches and removed. The small incisions are then cleaned, closed, and dressed.

Laparoscopic surgery is usually the best option for older adults and people who are overweight. It has fewer risks than an open appendectomy procedure, and generally has a shorter recovery time.

Do you know caring before surgery?

• Refrain from eating for at least 8 hours before surgery or last night
• Shaving your body (chest area to foot thighs and genital area)
• Doing enema if it's required
• Taking shower with anti-bacterial soap preferably.

Care after surgery

• Place in sitting position in order to decrease the pain, you can breathe better in this position
• You must keep the incision clean and dry. Your doctor will give you instructions on how to bathe. Any stitches or surgical staples used will be removed at a follow-up office visit. If adhesive strips were used, they should be kept dry. They will often fall off in a few days.
• Use prescribed pain medicines and anti-biotics after surgery
• Do not pick up heavy things after discharge and be able to normal activities in a couple of weeks, although you may need to avoid more strenuous activities for 4 to 6 weeks after open surgery.
• Do not be interested into walking soon, it may cause clots in foot veins
• Use your prescribed drugs according to doctor prescription

Do you think caring after surgery for prevention is side effect or not?

• Try to move your hands and feet in order to prevent a blood clot in veins and start walking from the next day after surgery in order to prevent this issue.
• In order to preventing lung side effect, after recovery try to breathe deeply and regarding having pain, try to cough. For less suffering, hold your hand on incision side

• For the first few days after the operation it's likely you'll have some pain and bruising. This improves over time, but you can take painkillers if necessary.

• Sometimes ask you to blow a balloon, this helps to prevent lung side effect.

References

1. Patient education in Gastrectomy.2011 A available at:

          http://www.upmc.com.Accessed Oct 20,2011

2. Patient education in colostomy.2011. A available at:

          http://www.nutrition care.Org Accessed Oct 20,2011

 

ISO 9001 Certification for Quality Management System &

Certification of Iran National Hospital Accreditation with Excellent Grade

Teaching Patients about

Appendicitis

Prepared by: Quality Improvement, Education and Research Office

Voice Costumer Service (For Complaints, compliments and comments)

SMS: 30001845

Pursuance: Hospital Management

Add: Iran, Mashhad, Shahid Mofatteh Street, Vahid Street, Vahid 3 Alley.

Phone: 32877001