Appendix Diseases

Appendicitis is an inflammation of the appendix which is believed to be developing due to blockage of its lumen.

What are the symptoms of appendicitis?

Most common symptoms of the appendicitis are pain in the abdomen, nausea, vomiting and fever. It can also present with diarrhea or frequency and burning of micturition. Although it can occur at any age, is more common in younger age
group.

How to diagnose appendicitis?

Although it can be diagnosed clinically, it requires some blood investigations and imaging study which can be ultrasonography or CT scan of abdomen.

What is the treatment of appendicitis?

The treatment of appendicitis is removal of appendix by surgery, which can be performed by two techniques – laparoscopic surgery or open surgery.

In laparoscopic surgery surgeon uses a “laparoscope” a long, thin tube like instrument which has a very small camera at the tip, which is inserted into the abdomen through a 0.5 to 1 cm cut. Image of the inside of abdomen is seen on
the TV screen. The abdomen is inflated with carbon dioxide gas to lift up the skin and muscle and make everything inside easier to see. Then the surgeon makes two 0.5cm incisions that allow narrow instruments enter in the abdomen. These tools include clamps, scissors, and stitching devices, which the surgeon can control from outside the body. While looking at the picture on the screen, the surgeon uses those instrumentss to perform the operation. Most appendix
removal surgeries nowadays are done using laparoscopic technique, but sometimes open surgery is necessary in complicated cases.

In open surgery, the surgeon makes a big enough cut on the abdomen to see the appendix directly and remove it.

What is the preferred surgical option?

Laparoscopic removal is preferred over open removal and nowadays most of the gallbladder removal surgery performed with laparoscopic technique.

What are the benefits of laparoscopic technique over open technique

Laparoscopic surgery is cosmetically better as it requires very small cut. It is associated with less pain, early discharge from the hospital and early return to the work. Generally patient requires only one day of hospitalization in laparoscopic surgery.

What is the risk of surgery?

Now a days risk of laparoscopic appendix removal is very low. It can be injury to surrounding structures, bleeding, infection and fever.

What is the postoperative course after surgery?

You will be allowed to take orally about 6 hours after surgery in uncomplicated situations, but it may take longer in certain circumstances. Hospital stay is usually 1 – 2 days, but it may be longer in complicated cases. After discharge from the hospital, you will be able to do routine normal activity immediately. Your doctor may advise you to take rest for 1 week, and to avoid heavy work like weight lifting, swimming for 1 – 2 weeks.

Types of Appendix Cancer

• Carcinoid tumours
• Non-carcinoid tumours
• Pseudomyxoma peritonei (PMP)
• Adenocarcinoid tumours

Symptoms

• Abdominal distention
• Acute or chronic abdominal pain
• Lower right abdominal discomfort
• Bowel obstruction
• Pelvic discomfort

Diagnosis

• CT or CAT (Computed Axial Tomography) scan
• MRI (Magnetic Resonance Imaging) scan
• PET (Positron Emission Tomography) scan

Treatment

• Surgery, chemotherapy