Dr. Ertan Beyatlı

How Does Appendicitis Burst?

(Update: ) - Digestive System Diseases

Appendicitis is a disease that can be seen at all ages. It is one of the most common causes of abdominal pain that requires surgery. If not operated, there may be a risk of death. It is difficult to diagnose, especially in children and the elderly.

Causes | Symptoms | Treatment | If not treated?

What is appendicitis?

The appendix is ​​a finger-shaped formation. It is at the junction of the large and small intestines. It is located in the lower right corner of the abdomen. Appendicitis is an inflammation of the appendix.

Appendix is ​​colloquially called appendix or cecum. Latin vermiform appendix dir (wormy).

The appendix does not function as a digestive organ in the human species and is thought to gradually disappear in the evolutionary process. However, it is claimed that the appendix cannot be considered as a vestigial organ due to its rich blood vessels and special histological structure. According to some studies intestinal flora The most important part of the balancing mechanism is the appendix.

Why does the appendix become inflamed?

The reason is not yet known. Food particles that cause clogging of the cervix (fecalith - fecalite - pheocoloid) and enlargement of lymph nodes located in the area (lymphadenitis or lymph hyperplasia) is thought to have developed as a result.

inflamed appendix - appendicitis

How do you know if you have appendicitis?

This disease widest range of symptoms It is one of the diseases that show. Most of the time, the diagnosis is made on clinical suspicion because the patient has general complaints at the beginning of the disease (nausea, stomach pain, anorexia, vomiting, weakness) examination findings may vary widely.

In a typical appendicitis disease, these complaints can be seen in the patient:

It starts in the stomach area or around the navel and spreads to the entire abdomen within a few hours and then within a few hours. in the lower right area of ​​the abdomen a settling pain. However, inactivity due to loss of appetite, nausea (rarely vomiting) and pain.

When the patient is examined, the lower right region of the abdomen local tenderness, defender, finding rovsing, and rebounding can be detected.

Situs In these cases, all organs in the body are replaced. For example, the heart would be on the right. In these cases, the appendix is ​​located in the left lower abdomen, not the right.

Recent studies are at the stage of diagnosis pain, loss of appetite, and rebound it has been described as the most valuable findings.

On abdominal ultrasound, swelling of the appendix, narrowing of the lumen and free fluid around it, as well as an increase in the level of white cells (WBC) in the blood test are supportive findings.

Pain + anorexia + rebound + USG + WBC

However, despite all these data, the diagnosis is still the surgeon's clinical experience It is placed depending on the location and the treatment phase is started without wasting time. For example, even in some cases of advanced and perforated appendicitis, all tests may be normal.

What is the Treatment for Appendicitis?

Treatment is surgery (appendectomy). In other words, it is the cut out of the inflamed gut. Treatment with medication and the use of antibiotics will not cure the disease. The appendix is ​​in a place where antibiotics are hard to reach.

Frames from appendectomy surgery ..

How long does appendicitis surgery take?

In cases where the appendix is ​​only inflamed, the average operation time is 20-40 minutes. In cases of complications (ruptured appendix, edematous phlegmone or blastrone appendicitis), this period may sometimes be 2-3 hours.

So What Happens If Appendicitis Is Not Treated?

Initially appendicitis (Acute Appendicitis) is very easy to treat. Under general anesthesia (by fainting), the inflamed cecum is removed with an operation for about 20 minutes, the patient is discharged the next day and stitches are removed at the end of the first week. Absorbed stitch types do not need to be removed (see: When Are Surgical Sutures Removed?)

Ancak in the absence of treatment Inflammation continues and edema and necrotic tissue occurs in the area (plastrone or phlegmone appendicitis), followed by perforation in the cecum (perforated appendicitis) and with the spread of the intestinal contents into the abdominal cavity (septic appendicitis) can lead to very dangerous and fatal consequences. In delayed cases postoperative complications, morbidity and mortality the rate is high.

During Perforated Appendicitis surgery - Dr. Ertan BEYATLI
A frame from Perforated Acute Appendicitis surgery - Ertan BEYATLI, MD, Çankırı / 2014
rotten and punctured (burst) appendicitis
The photo shows the perforation (puncture, bursting) area towards the tip of the appendix (black-white area).

Some diseases similar to appendicitis (Differential Diagnosis)

The surgeon also keeps these diseases in mind when diagnosing appendicitis:

  • A simple gas compression
  • Mesenteric lymph adenitis (especially in children)
  • Ovarian cyst rupture or ectopic pregnancy (for women)
  • Cholelithiasis (gallstones)
  • Nephrolithiasis (kidney stones)
  • Meckle diverticulum
  • Ileit
  • Peritonitis
  • Familial Mediterranean fever (FMF disease)
  • Intestinal inflammation (gastroenteritis, Yersiniosis)
  • Crohn's disease
  • Urinary tract inflammation (UTI)
  • Bleeding in the rectus muscle (hematoma)
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