Docyard : Don't ignore this pain

Appendix is a tube-shaped sac attached to and opening into the lower end of the large intestine in human beings and some other mammals. Appendicitis is a serious medical condition in which the appendix becomes inflamed and painful. This is one of those diseases which can affect people of any age group. This disease is mostly prevalent in the younger age groups of 12 to 25 years.  The symptoms include lower abdominal pain which then shifts to the right abdomen, just above the pubic bone.

Typical symptoms

• Dull pain near the navel or the upper abdomen, which becomes sharp as it moves to the lower right abdomen. This is usually the first sign.
• loss of appetite.
• Nausea and/or vomiting begin soon after abdominal pain.
• Abdominal swelling.
• Fever of 99 to 102 degrees Fahrenheit.
• Inability to pass gas.

Investigation: WBCs get elevated and also the patient needs to undergo tests, as there are many other diseases which mimic appendix. Ultrasound and laparoscopy are advised by the doctors. Treatment Appendectomy (open appendectomy or laparoscopy) is the available treatment option — a procedure where the appendix is removed.

Important issues

• Appendicitis can happen at any age: most prominent in children.
• Classical Symptom- high lower abdominal pain: with or without symptoms.
• Ultrasound is the usual investigation diagnosis.
• Appendectomy is the only treatment.
• n most cases, laparoscopy test is conducted and the patient needs to stay for 1 to 2 days at the hospital. 

Risks: Despite being a simple and safe procedure, some of the risks associated with appendectomy are bleeding, infection, injury to nearby organs, and blocked bowels.

Surgery: Before going forth with appendectomy, it is important for the patient to inform the doctor about any known allergies related to medicine and anaesthesia, history of bleeding disorders, and in case of female patients, pregnancy or recent pregnancy history. Doctors would generally ask the patients to avoid eating and drinking at least for the past 8 hours. Before beginning with the surgery, doctors would put the patient on intravenous drip for introducing fluids and medicines and on a local or general anaesthesia for a painless surgery. Depending upon the patient consent,  the doctors will either perform open appendectomy or laparoscopy.

Open appendectomy includes removing appendix by making an incision on the lower side of the abdomen and closing the wound with stitches after the appendix has been removed. In laparoscopy,  through few incisions, a cannula is introduced for inflating the abdomen with CO2 gas. The appendix is removed by locating it with the help of a laparoscope which contains a high-intensity light and high-resolution camera. After locating the appendix, it is stitched off and removed and the incisions are closed. 

After the surgery, the patient should lookout for signs of infection like redness and swelling around the incision, chills, vomiting, loss of appetite and stomach cramps, and fever of over 101F.

Appendicitis should essentially be identified and treated timely. It is fairly a safe procedure, and with due precautions, appendicitis is treated worldwide with a high success rate.

The writer is Dr Mriganka Shekhar Sharma Bariatric Surgeon Columbia Asia Hospital, Gurgaon