Appendicitis and Appendectomy - Medical Negligence Solicitors – Compensation Claims

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Appendicitis and Appendectomy

The appendix is a small, tubular organ located in the right lower quadrant of the abdomen, near where the small intestine meets the large intestine. It drains into the cecum and has, as its only function, some lymphatic tissue that makes antibodies for infection treatment.

Appendicitis happens when there is inflammation of the appendix. Some researchers believe the inflammation starts when the appendix gets blocked by a fecalith or hardened area of mucus. Bacteria build up inside the appendix and the individual gets an infection. If the infection spreads to the outside of the wall, the appendix is likely to rupture. A ruptured appendix spreads bacteria and inflammation throughout the abdomen, although the infection doesn’t usually travel far. In some cases, the body can wall off the appendiceal contents but in other cases, surgery is necessary. This usually happens in the elderly and when the patient receives antibiotics.

The main symptom of appendicitis is right lower quadrant abdominal pain. The pain starts out vague and centrally localized and travels to the right lower quadrant. There is often a loss of appetite, which goes into nausea and vomiting. When the appendix bursts, inflammation shows up in the peritoneum of the abdomen. Then the abdomen becomes more rigid and the pain is more central.

Appendicitis is usually treated with antibiotics and surgery. The antibiotics are usually started before the surgery is done. Some healthy patients have really well localized disease in their appendicitis and aren’t really sick. They are treated with antibiotics and watched for about 10 days. This is called having “confined appendicitis” and is one of the best kinds of appendicitis to have.

Others won’t see the doctor after the appendix has ruptured for many days or weeks. The infection forms an abscess the often requires both drainage and antibiotics. A drain is placed from the abscess to the outside until the abscess is sterile and resolved. It can take several weeks or several months before the abscess can be cleared. The actual appendix is removed after that time. This is known as an interval appendectomy.

In an appendectomy (traditional), the incision of 2-3 inches is made in the right lower quadrant of the stomach in the area of the appendix. The appendix is looked for and evaluated for infection. The appendix is freed up and is removed from the cecum. Everything is tied off and the incision is closed and dressed.

There have been newer techniques for taking care of appendicitis. Mostly, the techniques have used the laparoscope, which is a lighted tube/camera that makes use of small tools that accomplish the same thing as an open appendectomy. This leaves several small incisions that heal more easily than the one big incision. Patients get better much faster than they would if they have a larger single incision. A laparoscope can also make the diagnosis of appendicitis before going further and treating the problem or not treating anything at all.

If the appendix is not ruptured at all, the patient can go home from the hospital in 1-2 days. If the appendix was ruptured, then the patients stay is four to seven days. Sometimes a normal-looking appendix is seen and removed. It is deemed better to take out a normal appendix than to miss a slightly inflamed appendix during surgery.

The most common complication of appendicitis is bursting or rupture of the appendix. This kind of perforation can become a peri-appendiceal abscess or total abdominal peritonitis. The longer the time between infection and diagnosis or between diagnosis and surgery, the more likely it is that a perforation occurs. The risk of perforation if you wait 36 hours after the onset of symptoms is about 15 percent. There should be no delay between diagnosis and surgery.

Another complication is blockage of the cecum. This happens when inflammation creates a paralysis of the intestines so that intestinal movement does not happen. The small intestines fill with gas and liquid and the abdomen becomes distended. A more rare complication is sepsis following appendicitis. The bacteria spread to the bloodstream and the patient suffers a very severe, life-threatening infection.

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