What is appendicitis ?
An appendicitis is (usually) a bacterial inflammation of the appendix (appendix) of the cecum; an actual appendicitis is very rare, it is usually only the vermiform appendix.
The diagnosis appendicitis is sometimes simple, but often also very difficult set. When in doubt, it is normally about the removal of the appendix because it is much worse is an inflamed appendix inoperable (risk of perforation, followed by a life-threatening peritonitis and abscess formation), then a healthy appendix there (in hindsight) unnecessary out of it. About half of the removed appendices appears not fire afterwards. Appendicitis occurs mainly in young people, but can occur at any age.
Appendicitis symptoms and treatment
An appendicitis is manifested by pain in the right lower abdominal region especially. In classic cases is to this period of pain around the navel in advance. The patient is generally nauseous, sometimes gives over and has only rarely a normal appetite. This pain can be accompanied by fever, but not necessarily. Diarrhoea is a phenomenon. Emerge over time peritoneal irritation symptoms: Gently press the right lower abdomen hurts, then quickly remove the hand hurts again (rebound tenderness). Usually there are in the blood to find signs of inflammation in the form of an elevated erythrocyte sedimentation rate, and white blood cells more than normal. Its absence does not exclude the diagnosis is not completely out. Using ultrasound can be inconclusive in case of doubt about the diagnosis in many cases. Sometimes the appendix behind the intestine folded up. Then the location of the pain otherwise. Sometimes the muscle, which runs to the leg of the abdominal cavity, thereby irritated, causing the patient holds his right leg raised (psoas phenomenon). During pregnancy, the localization can be greatly increased, because the uterus the bowels upwardly.
A recommended the presumption of an "appendicitis" to go to the family doctor. If the doctor has a strong suspicion of appendicitis he will refer you to a hospital and then removal through surgery (appendectomy) usually the best treatment. This can be done in two ways: a small cut on the right side of the lower abdomen or through a keyhole surgery in which a number of minute incisions are made, after which the surgery is performed laparoscopically.
If we wait too long operations in the acute phase, made the free slip of the peritoneum and intestines are protective to the inflamed appendix back and forms a large mass in the abdomen, an inflammatory infiltrate. Once this has happened, one will often have to wait several weeks to months to men can operate.
Often preventive antibiotics after surgery through the drip.
Recovery after surgery
After a classical appendectomy is completely solid food usually after a day or five possible again. This depends on the recovery of the bowel movement. The overall recovery can take several weeks, all this depends on the condition of the patient. After a laparoscopic appendectomy patient may eat almost immediately and can usually go home within 24 hours, provided there are no complications; Also the recovery process much faster.
The laparoscopic technique the patient postoperatively suffered from shoulder pain. Causality is the carbon dioxide with bloated abdomen during the operation. This is necessary so that the intestines of each other come to lie, and the surgeon has a larger field of action in the abdominal area. At the close of the peritoneum, there is always a small amount of carbonic acid gas behind. The remains will stimulate the diaphragm (diaphragm) which shoulder pain occurs. The carbon dioxide will be transported quickly to the lungs. Through the lungs, carbon dioxide leaves the body and shoulder pain will pass quickly.
Complication
Perforation: we speak of a perforated appendix, when a hole in the wall occurred, causing a generalized peritonitis.
Chronic appendicitis
There are people who regularly slightly complaints reminiscent of an appendicitis. Sometimes renovate such people when the appendix is removed. It is not clear whether there is something like chronic appendicitis and how often this occurs.