Diagnosis
In most cases, appendicitis or appendicitis perforation can already be recognized by the symptoms of the affected person. The leading symptom of appendicitis is pain in the right lower abdomen. During the physical examination there are several signs and tests that indicate appendicitis, e.g. the Blumberg sign.
The doctor presses on the left lower abdomen and then suddenly releases. Letting go causes pain in the right lower abdomen. If the appendix has already ruptured, the pain may have spread to the whole abdomen. The diagnosis can be confirmed by an ultrasound.
The operation
To treat the perforation of the appendix, as well as appendicitis, the appendix is removed in an operation. However, not the entire appendix is removed, but only the small, thin appendix. Because only this appendix is inflamed.
This is called an appendectomy. The appendectomy can be performed openly through a 5-10 cm abdominal incision in the right lower abdomen or laparoscopically (with a specialized endoscope) through three small abdominal incisions. The procedure of choice is determined individually according to the location of the appendix, age, risk of complications and progress of the disease.
Today, the laparoscopic procedure is generally preferred. In both surgical procedures, the appendix is placed at its base at the actual appendix (caecum) and the vessels supplying the appendix are cut through. In the case of an appendix rupture, in addition to the appendectomy, the abdominal cavity must be completely freed from the leaked contents so that there is no (re)inflammation in the abdominal cavity after the operation.
For this purpose, the abdominal cavity is also rinsed with germicidal substances or antibiotics if necessary. Drainages may have to be laid through which wound fluid can still drain from the abdominal cavity after the operation. and therapy of appendicitis If the fracture of the appendix is covered by another organ, an abscess, an accumulation of pus, may occur.
This is cleared out during the operation and treated with antibiotics. Complications that can occur after the operation include Under certain circumstances it is also possible that the appendix has not been tightly sutured or the suture may leak due to further inflammatory processes in the body. This can lead to inflammation again.
In addition, there may be a temporary stoppage of bowel movement, which must be treated as soon as possible. All in all, appendectomy is a relatively small procedure with few complications, especially if the operation is performed early. These topics may also be of interest to you:
- Post-operative bleeding
- Infections
- Wound healing disorders
- Abscesses
- Intestinal abscess
- Intestinal obstruction
Many complications that can occur during surgery lead to the dreaded peritonitis, an inflammation in the abdominal cavity, if the problem is not recognized and treated in time.
The problem with peritonitis is that the inflammation spreads very easily in the abdominal cavity and can attack other organs, which then also become inflamed. Depending on the organ, this can lead to serious consequences. If other parts of the intestine are affected, there is a risk that these too will break through and disrupt the intestinal function.
Peritonitis is life-threatening and is usually treated with surgery and antibiotics. The intestinal arrest, which can be the result of the operation or peritonitis, leads to vomiting and pain. It can also lead to shock, a life-threatening circulatory disorder.
A rupture of the appendix is a life-threatening disease that must be treated as soon as possible, otherwise it can be fatal. The rupture creates a direct connection between the inside of the intestine and the free abdominal cavity. As a result, faeces and bacteria can enter the abdominal cavity from the intestine and cause peritonitis.
Bacteria can also enter the bloodstream and cause sepsis (“blood poisoning”). For this reason, if an appendix ruptures, surgery must be performed as soon as possible to prevent a fatal outcome. In the best case, appendicitis is therefore diagnosed and treated in good time, so that appendicitis can be prevented in the first place.
Adhesions usually occur after every operation. The peritoneum and the serosa, a skin that covers the abdominal viscera, grow together. Since the removal of the appendix is only a minor procedure, there is no pronounced formation of adhesions after the operation.
If a laparoscopic procedure was performed, the probability of adhesions is lower than after an open procedure. Adhesions usually do not cause any complaints. In some cases, they can lead to recurring pain or, in exceptional cases, they can pinch the bowel.
An appendectomy is a very short procedure. A removal of the appendix in the case of appendicitis without a through-book takes about 1 hour. Since in the case of an appendix rupture, the abdominal cavity is also cleaned of the leaked inflammatory material and the abdominal cavity must then be rinsed, the operation takes longer. Even an appendix that is difficult to access extends the duration of the operation.
