Appendicitis

Appendix is a blind ended finger like projection from a part f the large bowel (Caecum). It is a vestigial organ i.e. not serving any function in the body.

Appendicitis is inflammation of the appendix caused due to infection in the appendix which usually occurs due to the blockage of the lumen of the appendix by a fecal ball leading to accumulation of the infected contents within the lumen resulting into appendicitis.

Appendicitis can occur at any age but is more common in the the age group of 10-30 years.

 Common clinical features of the Appendicitis are:

• Sudden pain in the lower abdomen which usually starts around the naval and shifts to the right lower abdomen.
• Pain is followed by fever and vomiting which forms a diagnostic triad of shifting pain, fever and vomiting.
• Patient also complains for worsening of pain while movement and coughing and straining.
• Patient also experience loss or decreased appetite
• Abdominal bloating

Complications:

Serious complications can be associated with an attack of acute appendicitis. 

Appendicular perforation - rapidly progressive infection with in the appendix leads to its rupture and spreading of the infection within the abdominal cavity. This leads to sepsis (rapidly spreading infection in the blood) which can be life threatening. This usually requires urgent surgical intervention.

Appendicular Lump formation - Spreading of the infection outside the inflamed appendix, this results in formation of a lump which forms with the inflamed appendix, omentum, small bowel and large bowel. This condition is usually dealt with conservative management as surgery done with appendicular lump can be more extensive.

Appendicular Abscess - usually associated with perforation of appendix and formation of a pus pocket in the the lower abdomen. This usually requires drainage with the help of a tube drain placed in the abscess cavity.

Diagnosis:

• Routine blood tests
• Ultrasound abdomen
• Computed Tomography of the Abdomen
• Urine test

Differential diagnosis:

• Ureteric Calculi
• Ovarian Cyst
• Typhilitis (Inflammation of the Caecum)

Treatment:

Treatment is Surgical removal of the Appendix which is usually done by Minimally invasive method. Three small key hole incisions are made in the abdomen and the appendix is removed. The patient is usually discharged with in 24 hrs of the operative procedure.