Appendicitis is a common condition in second decade of life. The accuracy of diagnosis has improved by USG and CT Scan. Enthusiastic Lap surgeon will always prefer to do it Laparoscopically for the following reasons.
- The accuracy of diagnosis increases and if other conditions are found they can be managed with same ports
- It offers all the advantages of less pain, faster recovery, early return to work and less wound related complications.
- It offers great advantage in childbearing women because of many adnexal disease which can mimic appendicitis.
- In non acute phase it can be combined with other surgery
Evidence based medical practice and all Cochrane meta analysis prove the superiority of Lap Appendicectomy.
Laparoscopy can be preformed at any stage of acute appendicitis due to broad spectrum antibiotics
FAQ :-
What is the meaning of appendicitis?
It means inflammation of appendix (swelling & infection). The term acute means sudden development of the inflammatory process.
In whom does it occur the most?
It is most commonly seen in the second decade of life (adolescense), though it can occur in any age group.
What is the cause of appendicitis?
Appendix is a blind muscular tube present at the junction of small intestines with large intestines. 80% of cases of acute appendicitis are caused due to obstruction of lumen of appendix. The reason of obstruction could be a faecolith (i.e. hard faceal matter), worms if present in the intestines and rarely a foreign body.
What are the symptoms?
Usually the first symptom is pain around umblicus. After few hours the pain shifts to the right lower abdomen where the appendix is commonly present. A constant finding is that coughing causes increase in local pain. Pain is followed by nausea and vomiting. Other symptoms, which might be present are loose stools, burning while passing urine. These symptoms are than followed by a rise in temperature and an increase in blood white cell count, which is commonly known as TLC.
How a diagnosis of acute appendicitis is made?
The features of acute pain abdomen shifting to right lower abdomen with nausea, vomiting, fever and increased cell count indicates acute appendicitis which is the commonest abdominal emergency. There are various other conditions, which can mimic acute appendicitis. A prompt medical advice is mandatory to avoid the complications of acute appendicitis which can even become life threatening if the appendix ruptures.
Any special tests required?e?
If in doubt an ultrasound abdomen helps in reaching the diagnosis.
What are the complications of acute appendicitis?
If in doubt an ultrasound abdomen helps in reaching the diagnosis.
- Intra abdominal abscess
- Gangrene and rupture of appendix
- Septicemia
- Shock & death s
What is the treatment?
The treatment of acute appendicitis is removal of the appendix (i.e. appendicectomy). This can be done by an open technique or Laparoscopically. Laparoscopic appendicectomy is performed by making three tiny (3-5 mm) incisions through which the telescope and instruments are introduced and the appendix is removed. The advantage of laparoscopy over open technique is that the patient goes home within one day after surgery with almost no pain in contrast to open surgery where the patient stays in the hospital for a longer time with pain requiring injectable pain killers.
Don't we need appendix?
Appendix is a vestigial organ in humans and thus can be removed without any consequence.
Are there any side effects after removal of appendix?
There are no side effects as it has no function in the human body.
What if we don't get surgery done?
Surgery delayed or not done for acute appendicitis may lead to serious complications of formation of an abscess or rupture of appendix leading to life threatening infection and even death.
Which is a better procedure open or laparoscopic?
Both the procedures are equally effective in good, experienced hands. Laparoscopic has the advantage of lesser post operative pain, early recovery, good cosmesis as well as the chance to rule out any other pathology present in the same surgical sitting.
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