Wednesday, 11 January 2012

Its Just An Acute Appendicitis


Today I would like to talk about appendicitis. This is merely general information to all of you(non doctors) out there and I hope by the end of this topic, it educates patients to be more alert and seek treatment as soon as possible.

What is appendicitis? What are the symptoms and why do I choose this topic among all others? Of course, this is an emergency surgical case that if we took even a second of delay, it has higher chance to progress and contribute to higher mortality and morbidity. Appendix is a blunt end hollow organ filled with lymphatic tissue. Well, it plays a role in our immunity, especially in children.

It is located in right lower abdominal region(its most common place). The symptoms are simple - sudden onset of pain, pricking-like, increasing in severity, aggravated by food intake, fever(on and off), nausea and vomitting (these are the most common symptoms I usually see among my patients).

Well, as a surgeon, we see the patient as a whole. Besides appendix, there are several organs located exactly at the same location where appendix is situated. We have Meckel's diverticulum, cecum, ureter, ovaro-fallopian tube(for women) etc.

So please do not feel irritated when the doctor ask you as well other questions, because they need to exclude other diseases as well. Who knows, it could be urinary tract infection with appendicitis, or urinary tract infection alone or even appendicitis alone..sounds complicated isn't it?

After all clinical examinations are conducted and diagnosis established, we go in!

For me, I have already done 10-20 appendicectomy,  yet still have a kind of feeling while doing appendicectomy. It's just like playing cards....yeah right! Because we never know what we will encounter while going in until we see the last part of abdominal layer..sound interesting right? It could be easier or harder than before.

The palpitation begins just before the incision is made and I guess it will end only after the operation is completed. We never know how is the condition of the appendix,  is it perforated, suppurated? Will it be hard to find? Will there be lots of adhesion, that the appendix cant even be visualized and mobilized?!!

But even the 'simple' appendicectomy can be converted to laparatomy if the appendix is severely damaged or involves the caecum. This is how cruel appendicitis can be to someone.

Well guys, this is neither a medical lecture nor CME, so take it easy. It is just a general information which I'd like to share with you guys. From its clinical presentation to the surgeon's feeling while opening up in search for the appendix. :)

Have a good day. :)

EDITOR: Dr Aizat is currently serving as a junior medical officer in Surgical Department, in one of Malaysia's government hospital.

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