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| | Title: | Appendicitis. Part 2. | | Article: | Classically appendicitis starts as a pain that began in the periumbilical region (around navel - you belly pot). Then pain moves to the right lower quadrant of the abdomen. Nausea and vomiting often present after the onset of the pain. Classically, patient has low grade fever (this means around 37-38 C or 101-102 F), positive psoas sign (you stretch your leg and this movement increases your pain), positive Rovsing sign (Doctor pokes in your left lower quadrant of the abdomen, and you fill the pain in you right lower quadrant), Leukocytosis. Leukocytes are the white blood cells - WBC. Usually there are around 4000-9000 white cells per micro liter of you blood. When you have inflammation in you body the count goes up. Your pain during appendicitis classically localizes in Mc Burney's point. That is one third between your umbilicus and anterior superior iliac spine (this is the bony point that is sticking most prominently from your pelvis - you can palpate it yourself on the side of your belly). For confirmation a doctor also may try to elicit obturator sign - he will ask you to bend you knee and bring your heel to your groin - this manoeuver increases the pain during appendicitis. Similar test is the raising of the leg while you lie on the stretcher. That movement also increases your pain.
Appendicitis is the inflammation of appendix supposedly due to narrowing of this lumen. That narrowing may be caused by hyperplasia of appendix (means too big growth, overgrowth of the tissue) . That variant happens in children mostly. Another variant - is fecalith (small stony fecal material) that impacts into the appendix lumen. That is seen in young adults mostly. Appendix itself is a small part of gut . It is pencil-size sticking out gut. Gut is a continuos tube. Mouth is entry. Anus is exit. Appendix sticks out from the wall and ends blindly. It has only one entrance. Appendix is attached to the Caecum (part of gut - literally means blind colon in Latin). Appendix of ruminating animals (animals that chew grass, like cow) is very long and big. Appendix in humans is reduced to the pencil-size. However it doesn't disappear. There is a theory that appendix plays role in immune response. The walls of appendix are actually filled with lymphatic tissue containing lymphocytes (those are subtype of White Blood Cells). Lymphatics is responsible for immunity. The removal of appendix doesn't really change immunity significantly. Nonetheless, it is not something redundant. Unless it is inflamed there is no good reason to remove it . Now, acute appendicitis is the acute inflammation of appendix. Suffix "-itis" means inflammation in Latin. Appendicitis is also the most common cause of acute abdomen. Acute abdomen in surgery is a condition in abdomen that requires urgent actions, usually surgical. To diagnose appendicitis you need to have right lower quadrant pain. The pain should be present together with either appropriate history (all those classical signs and lack of appetite) or Leukocytosis (increase in white blood cells in the blood). Patients often ask questions: Can I avoid surgery? Can you treat me with antibiotics alone? You told me that it is possible to treat the appendicitis with antibiotics alone. Please, I do not want surgery, my mother (father, brother, fiancee) said that I can avoid surgery. The answer is: you can try to avoid it probably, but the odds of death are much higher if you treat appendicitis without surgery. Untreated appendicitis may lead to perforation in less than a day. Sun rises. Sun sets. Appendix bursts. So, the prompt surgical intervention is the main solution. On occasion, the surgeon may even find a normal-appearing appendix and no other problem explaining the symptoms. He may remove the appendix anyway because it is better to remove a normal-appearing appendix than to miss mild case of appendicitis. To cool down the infection before surgery doctors use antibiotics. Antibiotics may convert acute appendicitis into more chronic type. However the removal of the appendix is the choice.
www.kavokin.com | | Author: | Aleksandr Kavokin, MD, PhD | | System: | Appendix | | Subject: | Appendicitis | | Abstract: | Appendicitis is the inflammation of appendix supposedly due to narrowing of this lumen. | | Website: | http://www.kavokin.com | | Time: | 12:18 | | 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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