Cheers
April 15, 2024
Minutes To Read: 4

Appendicitis: Symptoms, Diagnosis and Treatment

Appendicitis is when there is inflammation of the appendix, which is a small lymphatic organ resembling the finger of a glove located in the first portion of the large intestine. This inflammatory-infectious problem most commonly occurs in people between the ages of 20 and 30 and can be extremely serious as if left untreated in time it can lead to death.

The appendix usually produces a constant volume of mucus that is drained into the caecum and mixes in the stool. The major problem is that this region is a dead end tube, which makes possible obstructions, which cause the inflammatory condition.

The causative elements of appendix obstruction are diverse. It may be due to an enlargement of lymphatic tissues in response to some viral or bacterial infection, parched pieces of feces, intestinal worms such as oxiuria, or even tumors.

When any of the above causes obstruction of the mucus drainage of the appendix, this fluid accumulates, causes the appendix to dilate, causes compression of the blood vessels and necrosis of the region.

If the case is not identified quickly, the appendix may rupture, which is called suppurative appendicitis.

Symptoms: When to Get Medical Help?

The physician, preferably a gastroenterologist, should be contacted if the person has symptoms of appendicitis, which are:

Lack of appetite;
Punctual, continuous and gradually increasing pain in the right side and lower abdomen;
Collapse in bowel function;
Fever;
Nausea, vomiting, fatigue and apathy.

The urgency of seeking medical help is even greater if:

The pain is severe, sudden or acute;
There is fever along with the pain;
The person is vomiting blood or has bloody diarrhea;
The abdomen is hard, rigid and sensitive to touch;
The person cannot evacuate, especially if they are vomiting as well;
There is chest, neck or shoulder pain;
Have dizziness or dizziness;
You are losing weight involuntarily;
Yellowing of the eyes or skin;
There is swelling for more than two days;
Burning while urinating or urinating more often than usual;
Are pregnant or possibly pregnant;
The pain gets worse when taking antacids or eating something.

Diagnosis

Doctors diagnose appendicitis by describing the patient's symptoms, physical examination, palpating the abdomen and noticing the patient's reaction, and laboratory tests and additional tests.

Differential diagnosis

It is important to understand that various inflammatory processes within the abdomen may resemble the symptoms of appendicitis, so it is necessary for the physician to make the differential diagnosis with the aid of abdominal computed tomography, abdominal ultrasound and diagnostic laparoscopy.

Examples of other diseases that have appendicitis-like symptoms are diverticulitis, Crohn's disease, pelvic inflammatory disease, Merckel's diverticulitis, and acute ileitis.

Chronic appendicitis

The symptoms of appendicitis may also appear cyclically. In these cases the diagnosis is usually chronic appendicitis, ie when there is obstruction and spontaneous clearance of the appendix. Therefore, if the patient has already had symptoms of appendicitis, but in previous examinations nothing has been revealed, he should mention the case for the doctor to evaluate the possibility of the problem being chronic.

Surgical treatment

Most treatments for appendix inflammation occur through a surgical procedure, as appendicitis in most cases requires rapid action because it can endanger the patient's life.

How is appendicitis surgery

Appendicitis surgery, also called appendectomy, can be done in two ways: extracting the appendix through a cut in the abdominal region; or by laparoscopy, where the appendix is removed from the navel and instruments and a small camera are operated on three other holes made.

Laparoscopic surgery allows for faster recovery, but is not indicated for all cases of appendicitis, as if an appendage rupture or spread of infection has occurred, open abdominal surgery is required to clear the abdominal cavity.

All types of surgery for appendicitis present few risks, failure to perform appendectomy, on the other hand, can be very serious and cause death.

Possible complications

Second, Antônio Falcão, a digestive surgeon, a member of the Brazilian Society of Laparoscopic Surgery, postoperative complications are mainly related to more complicated conditions, such as those in which the appendix is already punctured. In these cases there is more chance of problems such as:

Abnormal connections between abdominal organs or between these organs and the skin surface, called fistulas;
Bacterial abscess formation;
Peritoneum inflammation caused by bacteria due to leakage of feces and pus;
Septicemia and disseminated intravascular coagulation.

Postoperative

Generally, the length of hospital stay after surgery is one to two days and the patient can return to normal daily activities in one month, with restriction of major exertion only. Physical activities, for example, are released after three months.

Postoperatively indications for faster recovery are:

Avoid strenuous physical activity. In laparoscopy, in the first 3 to 5 days after the procedure, efforts should be avoided; already in open abdominal surgery, for 10 to 14 days after surgery;
Put a pillow on your belly and lightly press on your abdomen before coughing, laughing or making sudden movements to avoid pain at the surgery site;
Call your doctor if prescribed painkillers are not sufficient for pain;
Move slowly and slowly;
Sleep a lot.

Antibiotic Treatment

Treatment of appendicitis with antibiotics is also possible, according to a study by the Sahlgrenska Academy at the University of Gothenburg, Sweden, but the severity of the case needs to be assessed.

Study leader Jeanette Hansson says, "Some patients are in such serious condition that surgery is required, but 80% of people can be treated with antibiotics until they recover." That is, if appendicitis is identified early, it is possible to talk to the doctor about trying antibiotic treatment first.

Therefore, having a gastroenterologist as soon as you notice the symptoms of appendicitis is crucial, as it can help to establish the best treatment for the case to ensure recovery from this unexpectedly severe disease.