What is appendix?
It is a narrow, hollow muscular tube present near the junction of the small and large intestine. It has no significant function in human beings.
What do you mean by appendicitis?
It means inflammation of appendix (infection or swelling). 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 (adolescence), though it can occur in any age group.
What is the cause of appendicitis?
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 faecal matter), worms if present in the intestines and rarely a foreign body like seeds.
What are the symptoms?
Severe pain around the navel which shifts after few hours to the right lower abdomen. Coughing and straining cause an increase in the pain. Pain is accompanied by nausea and vomiting. Less common complaints include burning on passing urine and loose stools.
How is a diagnosis of acute appendicitis made?
The clinical signs and symptoms as mentioned above, are the most important indications for reaching a diagnosis. In addition, raised total blood count confirms the diagnosis. Acute appendicitis is the commonest abdominal emergency and requires surgery.
What is the treatment?
Any special tests required?
An abdomen ultrasound may help in reaching the diagnosis in case the clinical examination and other investigations are inconclusive.
What are the complications of acute appendicitis?
Gangrene and rupture of appendix causing generalised abdominal infection, Intra Abdominal Abscess (collection of pus) and Septicaemia (generalised, severe infection in blood) leading to catastrophic life threatening consequences.
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 (3-5-10 mm) incisions through which the telescope and instruments are introduced and the appendix is removed. The advantage of laparoscopy over open technique is less pain, early recovery and excellent cosmetic results. Also, laparoscopically the entire abdomen and pelvis can be inspected to rule out any other pathology.
Don't we need appendix?
Appendix is a vestigeal organ (something which has no well defined function) 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 definite function in the human body. It is a useful organ for animals where it helps in digestion.
Which is a better procedure-open or laparoscopic?
Laparoscopy has the advantage of lesser post operative pain, early recovery, good cosmetic results as well as the chance to rule out any other pathology present in the same surgical sitting. This is a method of choice in well equipped institutes having a trained surgical team.
Post operative instructions and information
- After the operation you will be kept in the recovery room. This period may vary from few minutes to few hours. The anaesthetist decides about your shifting to room. The decision depends on many technical factors.
- You will be sleepy immediately after the operation due to sedation given during anaesthesia and during the recovery period.
- You may have some discomfort when coming out of the effect of sedation. It gradually reduces to a tolerable level within a few minutes without any pain killer. However, if necessary you may ask for pain killer injections/tablets. You should try to avoid these drugs because they produce drowsiness and you may sleep for a longer period which is not desirable.
- You may feel nauseated in the immediate post-operative period, and you may even vomit which should not cause any worry. This generally gets over after few hours.
- You are generally allowed to have sips of water immediately after the operation and liquids on day of operation. In case of vomiting the liquid intake may be stopped and restarted after 30 minutes. The liquids may include water / cold drinks / tea / coffee / milk / juices or some clear soups.
- You are allowed to have normal home cooked meals of your choice from the next morning at breakfast.
- You should have small frequent meals for few days after operation following which you can resume your normal diet gradually. This is vital because you may feel bloated and distended if the quantity of food is in large quantities at a time.
- You should try to move the limbs and can sit up immediately after operation. You should also go to the toilet on your own. There are no restrictions whatsoever for the physical movement. In fact majority of the patients will feel much better after they have started the movement. The pain also dramatically reduces once you start sitting up, moving and walking.
- There is no restriction on your physical activity. You are allowed to walk as soon as you recover from your sleep. There is no restriction on climbing of stairs, lifting weight etc. You may even drive two wheelers or car as soon as you feel fit. This infact is one of the major advantages of the laparoscopic procedure.
- You will be discharged on the same day or next day of operation unless there is some associated medical/social problems. You are advised to visit again for follow up after 2-5 days when the dressings are removed. You should avoid wetting the dressings unless they are waterproof. After the removal of dressing, you can have normal bath with soap and water.
- In very few cases there may be some bloody/whitish discharge from the wound in the post operative period. This should not bother you because it is generally harmless. You can wipe the discharge and apply band-aid so as to avoid staining the clothes. If it is more you should report to the surgeon during the next visit. Please feel free to ask any question that may come to your mind.
We wish you a speedy recovery...
This is not a substitute for medical advice.
In case of a query, please contact your Doctor.