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Appendicitis

Appendicitis is the inflammation of the appendix. It is the most common surgical emergency. The appendix is a small, thin pouch about 4 to 8 long. It is connected to the large intestine and is at the lower right side of the abdomen. The appendix has no known function and may be removed without any harm. There is no known cause of appendicitis.

 

Appendicitis symptoms

Appendicitis typically starts with a pain in the middle of your abdomen (near the belly button) that may come and go. Soon, the pain travels to the lower right-hand side, where the appendix usually lies and becomes constant and severe. Pressing on this area, coughing or walking may make the pain worse. You may develop a fever, lose appetite and even have diarrhoea.

Appendicitis is often diagnosed from the history and examination. Often, a CT scan may be necessary to confirm the diagnosis. This is a very accurate scan with over 90% accuracy.

Treatment

If you have appendicitis, surgery is the standard of care and appendicectomy should be done as soon as possible to prevent further complications. It is most commonly carried out laparoscopically. Several small cuts are made in the abdomen, allowing special surgical instruments to be inserted. The main advantage of laparoscopic appendicectomy is a faster recovery with less pain. In uncomplicated cases, patients go home the next day.

Open surgery, where a larger, single cut is made in the abdomen, is usually used if the appendix has burst or if the appendix is deemed too difficult to be removed laparoscopically. Sometimes, an abdominal drain is inserted to drain out any remnant infection and to prevent an abscess (collection of pus).

It usually takes a couple of weeks to make a full recovery after your appendix has been removed. However, strenuous activities may need to be avoided for up to 6 weeks after having surgery.

Complications of surgery

But like all types of surgery, there are some risks, including:

• wound infection – although antibiotics will be given before, during or after the operation to minimise the risk of serious infections

• scarring –surgery will leave some scarring where the incisions were made. (Open surgery more than laparoscopic surgery)

• a collection of pus (abscess) –an infection caused by the appendix bursting can lead to an abscess after surgery even if a drain has been used.

• incisional hernia – at the site of the open incision or any of the incisions used in keyhole surgery