Appendicectomy

Definition

Appendicitis

The appendix is located at the base of the caecum, i.e. on the side lower right (in bottom and on the right) of the abdomen, but its length and position can be variable.  It can go up towards the liver, be in posterior position (retro-caecale) or on the contrary to go about the middle of the belly.
The pain of appendicitis can have a typical irradiation while generally starting around the umbilical point and while moving towards the right iliac pit. The intensity of the pain increases in general over a period from 12 to 6 p.m.
This pain in the right iliac pit, i.e. in bottom and on the right of belly, can join fever (in the neighbourhoods of 38°), nauseas or vomiting.
 Appendicitis occurs at any age but generally at the young people before 30 years
The standard treatment is the surgical ablation of the appendix.

 

  • The appendicectomy is the surgical urgency most frequent

Symptoms

Symptom and clinical signs

 

The diagnostic one of appendicitis is based on the interrogation of the patient and the private clinic
Signs and symptoms of appendicitis:
  • Pain

  • The pain starts around the umbilical point, then moves towards the right iliac pit.  

  • The pain worsens if you cough, goes or makes other movements.   

  • The pain can irradiate in the back Sensitivity to palpation by applying a pressure to with dimensions the line of the abdomen.

  • The pain can vary according to the position of the appendix and the ground of the patient.

  • The young children or the pregnant women, in particular, can have pains of appendicitis in places different from the abdomen.            

  • Sign of gravity

  • Positive Blumberg: Sharp pain with the decompression which occurs when you support the hand in right iliac pit and then slacken the pressure quickly

  • Other Symptom

  • Fever   

  • Loss of appetite

  • Nausea Vomiting

  • Stop of the transit to gas

  • Constipation /Diarrhée

 

To take an appointment with your doctor if you have signs or symptoms which worry you.

Any abdominal pain so serious that you makes unable to remain sitted or to find a position comfortable requires an attention

medical immediate.

  • Appendicitis can involve serious complications

    A perforation of the appendix can cause an abscess or a peritonitis, serious infection generalized of the cavity

    abdominal.

 

Diagnosis

Diagnose complementary

Sometimes the history of your signs and symptoms and a closer examination of your abdomen is not enough to establish with certainty it

diagnosis of appendicitis.
 

Before the possible appendicectomy of the complementary examinations are necessary

  • To note

  • Biological examinations (blood test)

  • The blood test could show an inflammatory syndrome

  • with a rise in white globules, known as hyperleucocytosis, and CRP

  • Sometimes un’ scans or a CT scanner (TDM) makes it possible to confirm the existence of appendicitis and to exclude from other causes of the pain

  • Techniques of imagery

Surgical treatment

Appendicectomy

The treatment generally implies a surgical operation, known as appendicectomy, with an aim of removing the ignited appendix.

appendicite

The appendicectomy is carried out either by invasive mini way (coelioscopy/laparoscopy) or by open surgery by using an incision
abdominal of 3-6 centimetres.
The appendicectomy by laparoscopy implies 2 small incisions cutaneous (3 mm or 5 mm) more the incision for the camera (10 mm).
The appendix is dissected and removed under video control thanks to special instruments.
In general, the laparoscopic surgery enables you to recover more quickly and to have an aesthetic advantage (scars limited).

But the laparoscopic surgery is not possible in all the cases.

If the infection were propagated, if an abscess were formed, an appendicectomy by open way can be necessary to clean the cavity

abdominal.

The choice of an antibiotic medical care to the long course can be necessary according to your situation: old infection with

bulk-heading of the area cæcal (appendicular drill plate), presence of an appendicular drill plate.

 

The antibiotic treatment can be associated with a radiological drainage with a possible collection while placing a tube with drainage through

skin and with a possible surgery of remote appendicectomy (a few weeks later after control of the infection).

Convalescence

Convalescence after appendicectomy

If your appendicitis were serious – associated appendicular abscess, generalized peritonitis it will be necessary to take more time to recover.

If you had an opened appendicectomy, it is necessary to limit the activity for the 10 to the first 14 days after the surgery.

 If the appendicectomy were made by laparoscopy (coelioscopy), you will limit your activity only the first 5 days after the surgery.

 

Avoid the intense physical-activities at the beginning.

Stop of the sport for two to four weeks after the surgery.

Start with walks and then increase your activity slowly.

Compress your abdomen when you cough. You can feel pains at the time of cough, the laughter or other movements

You can turn over to work if you feel with the height.

Ask your doctor if you can return to your normal activities

Call your doctor if your drugs against the pain are not effective

Complications

Complications Appendicectomy

  • general complications (related to any abdominal surgery)

  • phlebitis

  • pulmonary embolism

  • haemorrhage

  • infection on the level of the incision, the urinary probe, a venous way

  • occlusion and attaches intra-peritoneal

  • conversion of the laparoscopy into conventional surgery

  • rare (local rehandlings, adherences, engineering problems, generalized peritonitis)

 

  • Persistence of an infection of the abdominal cavity

  • The formation of a deep abscess can require a radiological or surgical complementary treatment