When Appendicitis Strikes

Appendicitis can strike anyone at any age, though it is most common between 10 and 30 years of age. It is usually regarded as a medical emergency that requires immediate attention.

Why it happens?

Appendicitis happens when there is an infection or inflammation of the appendix. It is also believed that blockage of the lumen of the appendix, usually by a lump of hard stools. The mucus produced by the lining of the appendix then becomes trapped and the appendix becomes swollen. The pressure affects the blood flowing in the wall of the appendix, and eventually causes it to break and burst open, releasing all the infected material into the abdominal cavity.

Signs of appendicitis

The swollen and inflamed appendix results in pain in the lower right side of the tummy and increases in intensity; it also causes nausea, vomiting, and fever. Less typical symptoms such as diarrhoea, constipation, back pain, painful urination and severe cramps.  If you experience these symptoms, seek medical attention immediately. Avoid eating, drinking, or using any pain remedies, antacids, laxatives, or heating pads, which can aggravate the inflamed appendix.

Tests for appendicitis

Abdominal examination by palpating and having pain in the abdomen only confirms the presence of inflammation and / or infection in the lining of the abdominal cavity below the area being pressed. It does not indicate the source of the inflammation or infection. The most accurate test is a CT scan. Other tests such as blood tests is done to see if your body is fighting an infection. This has been reported to have accuracy of only 50%.

Treatment

Almost all cases of appendicitis require the appendix surgery to be removed.

Open surgery – this is the traditional way in which a cut is made across the lower right side of the abdomen and the appendix is removed through the cut. The cut is usually at least 4-5 cm long and can be even longer if there is severe infection around the appendix.

Laparoscopic (keyhole) surgery – this is quite common nowadays. A cut is made at the umbilicus and a camera is inserted. Two small 5mm cuts are made further below to put in the instruments to free up the appendix and cut it off. The appendix is then removed through the cut at the umbilicus.

Single port surgery – this is a variation of laparoscopic surgery in which a special device is inserted at the umbilicus. All the instruments are placed through the device, thus avoiding the other two small 5mm cuts. The surgery is performed in exactly the same way as the standard laparoscopic surgery.

Most patients are discharged within 1-2 days after surgery. However, those with severe infection or abscess from an appendix that has perforated may need to stay longer until the infection is resolved. Hence, it is important to seek treatment early when symptoms of pain arise.