Appendicitis (inflammation of the appendix)

Appendicitis (inflammation of the appendix)
International Classification (ICD) K37

Basics

Appendicitis means that the vermiform appendix of the large intestine is inflamed. It is about the size of a little finger and is located in the ascending part of the colon. It plays virtually no role in digestion, but is thought to help protect intestinal bacteria.

Approximately 7% of the population, mostly between the ages of 10-30, experience appendicitis. This makes appendicitis the most common disease of the abdomen requiring surgery.

Causes

Appendicitis can have different causes:

- Often parts of the intestinal contents get caught in the appendix, thus leading to a blockage and, as a consequence, to an inflammation.

- Sometimes it is also fruit stones, parasites (for example worms) or even tumours that block the appendix vermiformis.

- It can also happen that the whole colon is inflamed. Then, of course, it easily spreads to the appendix.

- If pathogenic bacteria settle in the appendix area, the body can also react with an inflammatory reaction.

Symptoms

In addition to decreased appetite, nausea (sickness) and vomiting, at the beginning there is pain around the navel region, which then shifts to the lower right after several hours and increases when standing up and walking.

Unfortunately, these symptoms do not show up as clearly in young children, expectant mothers, and the elderly. They occur more diffusely and in older people at all weaker, which means that appendicitis is often diagnosed late.

Diagnosis

If in a blood test, the leukocyte count (number of white blood cells) is increased, there is a high probability that there is inflammation in the organism.

In addition, there are special points in the abdomen that hurt when touched in case of appendicitis (McBurney point and Lanz point).

In order to rule out other diseases, women should also see a gynecologist, have their ovaries examined and take a pregnancy test.

In order to make a definite diagnosis, a urine test and an ultrasound can also be carried out. If you are not sure whether the appendix is inflamed, you should still have surgery, because the consequences of overlooked appendicitis can be fatal. Perforation can occur, which means that the appendix bursts open and pus and bacteria spread throughout the abdominal cavity, leading to peritonitis.

Therapy

You can treat appendicitis with 2 different types of surgery.

Conventional surgery:

Through a relatively large incision (5 cm long) on the lower right side of the abdomen, the appendix vermiformis is cut out and the opening is sutured shut afterwards.

Laparoscopic surgery:

This method is preferred because only 3 buttonhole-sized incisions need to be made. A camera with a light source is inserted into one of the openings. It films the gas-filled abdominal cavity, which is then projected onto a screen. The required surgical instruments are inserted through the other 2 holes. Here, too, the appendix is cut off and removed through one of the openings.

Forecast

If appendicitis is detected early enough and operated on, there is no great danger.

However, there is a danger to life in the event of a perforation (rupture of the appendix), whereby pus empties into the abdominal cavity and inflammation of the peritoneum follows. In this case, surgery must be performed immediately and strong antibiotics administered.

Sometimes it happens that the intestinal loops stick to each other after the operation due to scarring (adhesions) and then another operation must be performed.

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