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[R191]Removal Of The Appendix

by Groshan Fabiola, Gro

Thousands of children have their appendix unnecessary removed because of the lack of experience of the surgeons. About 8% of the appendectomies are unjustified in spite of appendicitis being the most common pediatric disease. Children must undergo a surgical operation that finally proves a normal healthy appendix.

Although appendicitis may seem easy to diagnose, difficulties can appear due to the symptoms assembling to the manifestations of other disorders in the area. Complains like abdominal pain, nausea, vomiting and fever can be caused by intestinal infections or especially by genital pathology in young girls. No test for appendicitis can be 100% accurate.

Wrong diagnosis is much rarer in pediatric hospitals with experienced surgeons, which have performed more appendectomies, and mostly recommend X-ray exams, CT-scan or ultrasonography before establishing a certain diagnosis.

In spite of these mistakes, appendectomies cannot be performed only in big hospitals, together with more complex and risking operations such as heart transplant or coronary by-passes. Appendicitis shouldn't be a disease to require the hospitalization and medical care of a major medical centre. If so, these clinics would be overwhelmed by the number of patients and the smaller children hospitals would remain without medical cases.

Surgeons all over the world tend to accept the possibility of removing a healthy appendix, a small segment hanging from the Ilion with no particularly important function. And this because they prefer to remove a normal appendix than risk major complications like perforation, generalized peritonitis or even death.

Usually the doctors explain the patients or their caretakers there is a possibility to remove a healthy appendix because the appendicitis diagnosis isn't accurate. The certainty of appendicitis can only be established intra-operator, when the surgeon extracts a ?red worm? meaning an inflamed, infected appendix or a ?white worm?, a normal one. Operating doctors usually expect to find 15% whit worms during appendectomies.

Patients are informed before surgical intervention that they will get a 1-2 inch incision by classical surgery method or three smaller ones while laparoscopic appendectomy is performed.

Recent studies and research have confirmed the worthless tolerance of errors within appendicitis diagnosis and appendectomies. Scientists claim, needless appendectomies in adults lead to a minimum of 6 days hospitalization required, a lost period of time that could affect one's business or familiar activity. One patient in 40 develop further complications after surgery and need prolonged medical care and about 1.5% of the operated persons die.

Appendectomy starts with the performing of an incision 4-7 centimetres of length from the skin to the appendicle area. By this incision, the appendix is searched for, in the lower right side abdominal area and in absence of other complications, is removed and detached from the colon, then the hole in the large intestine is sealed. In case of abscess, tubes made of rubber called drains will remove the pus and take it out through the skin. The last step is the closing of the incision.

Laparoscopy is a new procedure that gains more and more frequency although general anaesthesia is necessary, because it allows the doctor to see the inner abdomen by means of a very small incision. If appendicitis is found, special medical tools are inserted into the abdomen. This procedure gained popularity because it is less painful and a smaller amount of time is necessary for recovery, but also due to the fact that it gives a certitude regarding diagnosis and can also identify other conditions miming appendicitis.

Except for serious cases with appendix rupture involved, the patient is kept in the hospital for only one or two days. But in the first case, they remain in the hospital under close observation for a week, especially in case of peritonitis and administered antibiotics intravenously to eradicate the infection.

Even if the appendix has a normal look and structure, it still needs to be removed by the doctors, because they cannot ignore the possibility of further inflammation and eventual complication, so it is safer to take out a healthy appendix than to allow a possible problem to persist.

Complications

The causes of appendicitis are not certain. In some cases it can be determined by residual food or a piece of stool blocked inside the appendix. Other causes of this condition can be inflammations of any kind or infections caused by bacterial invasion, which fills the appendix with pus, situation in which rupture may appear.

Peritonitis is the most severe complication generated by appendicitis and represents an emergency. Even if it is discovered and treated immediately, it still remains a very serious problem in some cases. This disease consists in infecting the lining of your abdominal cavity, following appendix perforation, and spilling the infectious organisms it contains into your peritoneal cavity. The first sensation that follows this rupture is of pain relief, but immediately replaced by full abdominal area pain, caused by fluids and gases. It is possible in case of peritonitis for the pain not to locate in the appendicle area but a bowl or the inability to release gas accompanied by fever, the sensation of thirst and a smaller amount of urine should immediately alarm you.

More exposed to the risk of appendix rupture than the adults, are the children, whose symptoms are often untypical causing a delay of diagnosis and treatment so that pain in the abdominal area should be taken very seriously. Medical advice is recommended.

A collection of the infection which forms an abscess of the appendix varying in size can be very dangerous if not removed in time, because the rupture of such abscess generates in most of the cases peritonitis.

Article Source : Pg. 247

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Both Groshan Fabiola & Sebastian Bunten are contributors for EditorialToday. The above articles have been edited for relevancy and timeliness. All write-ups, reviews, tips and guides published by EditorialToday.com and its partners or affiliates are for informational purposes only. They should not be used for any legal or any other type of advice. We do not endorse any author, contributor, writer or article posted by our team.

Groshan Fabiola has sinced written about articles on various topics from Woman Menopause, Medical Condition and Health. For more resources about or even about. Groshan Fabiola's top article generates over 6120000 views. to your Favourites.

Sebastian Bunten has sinced written about articles on various topics from Blood Pressure, Health and Blood Pressure. Read more facts about ,. Sebastian Bunten's top article generates over 90500 views. to your Favourites.