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| | Title: | Appendicitis. Part 3. | | Article: | With modern technology it becomes much easier to distinguish appendicitis and other causes of pain in right lower quadrant. Yet there is no 100% proof diagnostics. Sometime doctors treat with antibiotics alone, when they are not sure. Though, modern CT-scan shows appendicitis almost close to 100%. What would happen if you miss the appendicitis and appendix bursts? You will get one of the most dreaded surgical complication - peritonitis. Again, "-itis" equals inflammation. Peritoneum means the peritoneal cavity. It is difficult to describe the shape of the peritoneal cavity . That shape is very complex. Simple explanation: peritoneal cavity is like a closed bag. It is completely closed in males Female have small holes in the peritoneum. Oocytes (future babies) go from ovaries first to peritoneal cavity. The holes in the peritoneum allow oocyte to go into Fallopian tubes. Fallopian tubes lead into the uterus (womb in English or hyster in Latin or uterus in Greek). Organs that are covered by peritoneal cavity linings are named intra-peritoneal. There are also melo-peritoneal, extra-peritoneal or retro-peritoneal organs that covered partially or not covered at all. It looks like the main function of peritoneum (peritoneal cavity) is to give some lubrication to your guts. Though there are other functions as well. Now, take a plastic bag, pour a little bit of water or oil into it and seal. Put one hand on one side of the bag, another hand - on another side of the bag and rub against each other. You can see your hands slide easily. This is the idea of peritoneum - you bowels slide easily against each other even when they are stretched by food and when they are pushing the digested food down. When a bowel is punctured (perforated), the content of the bowel will go into the peritoneal cavity. Colon (lower, bigger bowl) has the fecal material. Fecal material consists of bacteria on 2/3 (yeah, there are so many of them). Now, that small puncture in one part of the gut will cause spillage of the bacteria all around that closed bag of peritoneum. Guts on inside have several mechanisms protecting from bacteria. Peritoneal cavity doesn't' have such a protection. Small puncture in one part of gut will cause all of you guts be inflamed on outside non-protected side (for the gut it is outside, but for the peritoneal cavity it is the inside). This is the peritonitis (diffuse). This what the surgeons are afraid of. Look at you. You belly is like half of you body. So it is like half of you body is severely inflamed. Eventually it may lead to sepsis, a condition in which bacteria enter the blood and infect other parts of the body. This is life-threatening complication. Sometime inflammation stays local and seals off forming an abscess. Abscess is the walled off accumulation of pus. Pus is the mixture of dead and alive bacteria, dead white blood cells (leukocytes; leukos = white, cyte = cell) that fought the infection and honorably died, and dead tissue, that was digested partially by bacteria and partially by the stuff from leukocytes. Inflamed peritoneum (the lining of the peritoneal cavity is also named peritoneum) easily adhere to each other and may seal of the infection - there will be local peritonitis. Any adherence may cause problems in the future - guts do not slide easily anymore and food or stool sticks. Blockage of the intestine may occur in acute appendicitis as well. This is partially responsible for the nausea and vomiting. Sometimes, when antibiotics are used, appendicitis goes away without surgical treatment. It happens in elderly patients. The patients may come to the hospital with a lump or a mass in the right lower abdomen looking like tumor.
www.kavokin.com | | Author: | Aleksandr Kavokin, MD, PhD | | System: | Appendix | | Subject: | Appendicitis | | Abstract: | This is the peritonitis (diffuse). This what the surgeons are afraid of. Look at you. You belly is like half of you body. | | Website: | http://www.kavokin.com | | Time: | 12:17 | | Reference: | http://www.rdoctor.com | | Reference 2: | http://www.symptomat.com |
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Articles by Aleksandr Kavokin, MD, PhD
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