Appendicitis

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Overview

Appendicitis is inflammation of the vermiform appendix. Appendix a hollow organ located at the tip of the cecum, usually in the right lower quadrant of the abdomen. However, it can be located in almost any area of the abdomen, depending on if there were any abnormal developmental issues, including midgut malrotation, or if there are any other special conditions such as pregnancy or prior abdominal surgeries. The appendix develops embryonically in the fifth week. There is a rotation of the midgut to the external umbilical cord with the eventual return to the abdomen and rotation of the cecum. This results in the usual retrocecal location of the appendix. It is often a disease of acute presentation, usually within 24 hours, but it can also present as a more chronic condition. If there has been a perforation with a contained abscess, the presenting symptoms can be more indolent. The exact function of the appendix has been a debated topic. Today it is accepted that this organ may have an immunoprotective function and acts as a lymphoid organ, especially in the younger person. Other theories contend that the appendix acts as a storage vessel for "good" colonic bacteria. Still, others argue that it is a mere developmental remnant and has no real function.

Symptoms

Sudden pain that begins on the right side of the lower abdomen.

Sudden pain that begins around your navel and often shifts to your lower right abdomen.

Pain that worsens if you cough, walk or make other jarring movements.

Nausea and vomiting.

Loss of appetite.

Causes

Appendicitis may be caused by various infections such as virus, bacteria, or parasites, in your digestive tract. Or it may happen when the tube that joins your large intestine and appendix is blocked or trapped by stool. Sometimes tumors can cause appendicitis. The appendix then becomes sore and swollen.

A blockage in the lining of the appendix that results in infection is the likely cause of appendicitis. The bacteria multiply rapidly, causing the appendix to become inflamed, swollen and filled with pus. If not treated promptly, the appendix can rupture.

Risk factors

Age. Appendicitis most often affects teens and people in their 20s , but it can occur at any age.

Sex. Appendicitis is more common in males than females.

Family history. People who have a family history of appendicitis are at heightened risk of developing it.

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Complications

Postoperative abscesses, hematomas, and wound complications are all complications that can be seen after appendectomies. If the wound does get infected, one may grow Bacteroides. "Recurrent" or "stump" appendicitis can occur if too much of the appendiceal stump is left after an appendectomy. This acts just like an appendix and can become occluded and infected just as with the initial episode. Therefore, it is important to ensure that there be very minimal and preferably less than 0.5 cm appendiceal stumps after an appendectomy. If left untreated, appendicitis can lead to abscess formation with the development of an enterocutaneous fistula. Diffuse peritonitis and sepsis can also develop, which may progress to significant morbidity and possible death.

Prevention

There's no proven way to prevent appendicitis. Eating a high-fiber diet with lots of whole grains and fresh fruits and vegetables may help,

Oats or wheat gram over breakfast cereals.

Whole wheat flour instead of all-purpose flour.

Brown rice instead of white rice.

Fresh fruits for dessert.