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Suwasáriya(Healthnet)
Appendicitis

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Author - Dr. H. P. S. Damayanthi (M.B.B.S., D.F.M)

Author 2 - Dr. Ranjith Ellawala (MS,FRCS) Consultant Surgeon

Institution - H.E.B

Introduction

Appendicitis is a swelling of the appendix. It is regarded as emergency because a ruptured appendix can lead to potentially serious or even fatal complications.

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What and where is the appendix?

The appendix is a small 'dead end' pouch, like a little tube, that comes off the caecum. The caecum is the first part of the large intestine (large bowel) just before the colon. The small intestine digests and absorbs food. The parts of the food that are not digested begin to be formed into faeces (motions) in the caecum.

The appendix is normally about 5-10 cm long and quite thin. The appendix appears to have no function. The reason it is there is a bit of a mystery.

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What is appendicitis?

Appendicitis


Appendicitis means inflammation of the appendix. The inflamed appendix becomes infected with bacteria (germs) from the intestine. The inflamed appendix gradually swells and fills with pus. Eventually, if not treated, the swollen appendix might perforate (burst). This is very serious as the contents of the intestine then spill into the abdominal cavity. This can cause a serious infection of the membrane that lines the abdomen (peritonitis), or an abscess in the abdomen. So, if appendicitis is suspected, early treatment is best before it bursts.

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Who gets appendicitis?

Appendicitis is common and can affect anyone of any age. Teenagers and young adults are the most commonly affected. It is slightly more common in men than women.

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What causes appendicitis?

The reason why the appendix becomes inflamed in the first place is not known in most cases. Some cases are thought to be due to a blockage that occurs somewhere along the short appendix. This may be due to some hard faeces  that get stuck. Bacteria may then thrive and cause inflammation behind the blockage in the 'dead end' of the appendix.

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What are the symptoms of appendicitis?

Pain in the abdomen (tummy pain) is usually the main symptom. Commonly, the pain starts in the middle of the abdomen. The pain normally develops quickly, over an hour or so. Over the next few hours the pain typically 'travels' to the lower right-hand side of the abdomen. This is over where the appendix normally lies.

Typically the pain becomes worse and worse over 6-24 hours. The pain may become severe. The pain tends to be sharper if you cough or make any jarring movements. The pain may ease a bit if you pull your knees up towards your chest. The lower abdomen is usually tender, particularly in the lower right-hand side.

Other symptoms that may occur include the following.

  • Feeling sick and being off food is typical. You may vomit.
  • Fever and generally feeling unwell.
  • Constipation may occur. Sometimes diarrhoea.
  • Frequent passing of urine may develop.

If the appendix perforates (bursts) then severe pain can spread to all the abdomen. You also become very ill.

Management - You will be admitted to hospital if appendicitis is suspected.

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References - NICE guide lines

Belly and love –surgical practice

www.patient.com - uk

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Last update on : 2011-03-23 14:44:32