Appendicitis
What is The Appendix and Appendicitis?
The appendix is a small pouch located near the junction of the small and large bowel in the tummy. The appendix does not serve any known significant function in humans.
Inflammation or infection of the appendix is known as appendicitis.
What are the causes and risk factors of Appendicitis?
The cause of appendicitis is usually unknown. However, there are some factors may lead to higher risk such as:
- Age: Most common in people between 10 and 30 years old.
- Gender: More common in males.
- Family history: Having a family history of appendicitis.
- Previous episodes: Higher risk if you’ve had history of appendicitis (treated medically).
- Obstruction: Blockage of the appendix by stool, foreign bodies, or tumours.
What are the common symptoms of Appendicitis?
Symptoms of an acute appendicitis may include:
- Abdominal pain: Typically starts around the belly button and moves to the lower right abdomen.
- Loss of appetite: Sudden decrease in appetite and feeling of fullness.
- Nausea and vomiting: Common non-specific symptoms when feeling unwell.
- Fever: Low-grade fever, usually ranging from 99°F (37.2°C) to 100.5°F (38.1°C).
How to diagnose acute Appendicitis?
- Physical Examination: Acute abdominal tenderness. There is usually pinpoint pain at right lower abdomen with rebound pain.
- Laboratory Tests: White blood count and inflammatory markers such as CRP may be raised.
- Imaging: Computed Tomography (CT) scan help visualise the appendix and identify signs of inflammation. It can also help to exclude other pathology such as diverticulitis.
What are the treatment options for Appendicitis?
- Surgery: Surgical removal of the inflamed appendix called appendectomy. This is usually done via Laparoscopic (keyhole) approach.
- Conservative: Administration of antibiotics in selected cases (e.g. minimal symptoms and mild changes on CT). However there is risk of treatment failure and also the possibility of appendicitis recurrence in the future.
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More on laparoscopic Appendectomy
- Procedure is done under general anaesthesia.
- Minimally invasive surgical technique (keyhole) for removing the appendix.
- Three small cuts are made in the abdomen, with the use of specialised instruments and a laparoscope.
- Provides clear visualisation and precise removal of the appendix.
- Benefits include reduced trauma, shorter hospital stay, faster recovery, and lesser pain.
What are the potential complications?
Risks of Laparoscopic Appendectomy:
- Injury to surrounding organs: A small risk of unintentional damage to nearby structures such as bowel or bladder.
- Bleeding: Small risk of bleeding during or after the surgery.
- Infection: Possibility of infection at incision sites or within the abdomen, especially if the appendix has ruptured before surgery.
- Conversion to open surgery: There is a small chance of converting the surgery to open method.
What is the recovery process after surgery?
- Hospital stay: Patients usually stay in hospital 1-2 days after surgery.
- Pain killers and antibiotics are usually prescribed for 1-2 weeks after surgery.
- Avoid heavy objects lifting up to 2 months after surgery.
- Regular follow up in clinic until the wound is fully healed.
- Patients aged 50 years and above are strongly recommended to undergo a colonoscopy to evaluate their colon health and rule out any other potential pathological conditions. Colonoscopy is typically scheduled to take place within 6-8 weeks after the surgery.
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