1. What is acute appendicitis?
Appendicitis is an inflammation of the appendix. A blockage in the lumen of the appendix leading to an infection is most likely the cause of appendicitis. The bacteria multiply rapidly, causing the appendix to become inflamed, swollen, and filled with pus. If not treated quickly, the appendix can rupture.
2. Symptoms of appendicitis:
- Abdominal pain:
It is the first and always present symptom. Abdominal pain in inflammatory appendicitis can be typical: pain with onset in the umbilicus or epigastrium accompanied by nausea or vomiting. After about 2-12 hours, the pain gradually increases and moves down to the right iliac fossa, continuous dull pain and increases when coughing or changing position …
Abdominal pain is the most common symptom of appendicitis
Depending on the location of the appendix, the patient will have a very different feeling about the location of abdominal pain in appendicitis: hip pain (postcecal appendix), hypogastric pain (small appendix), …
In addition to the nature of the abdominal pain in appendicitis depends on many other factors
+ Medicines in uses
+ Patient’s endurance
+ Patient’s resistance
+ Patient’s medical condition
- Fever:
Usually a fever or a low-grade fever of approximately 38 degrees Celsius is due to an infection of the appendix. If there is a complication of peritonitis, the infection is severe, causing high fever.
- Nausea:
This is a sign of acute appendicitis and always appears after abdominal pain. However, this symptom can be misleading with other diseases such as gastritis or food poisoning.
- Diarrhea:
Diarrhea is only seen in some special cases such as appendicitis of the pelvis or appendix that has ruptured, creating inflammation in the sac of Douglas (lowest area of the abdomen when standing) causing irritation to defecate.
3. Causes of appendicitis:
Currently, the main cause of appendicitis remains unknown. The appendix becomes inflamed and infected when the lumen of the appendix is blocked, causing the appendix to become ischemic and creating conditions for the inflammatory virus to attack. The infection reduces blood flow to the appendix and necrotic cecum. Prolonged obstruction and inflammation can cause the appendix to rupture or perforate.
4. Complications of appendicitis:
If not diagnosed and treated promptly, it can lead to the following complication:
– Perforated appendix: When the appendix bursts, bacteria spill over into the abdomen and can be life-threatening. Surgery to remove the appendix and clean the abdomen is required immediately
– Abdominal abscess: when the appendix is left for a long time or improperly treated, the organs in the abdomen such as the small intestine, the great omentum,… come to cover the pus-filled cavity, forming a localized pus-filled pocket in the abdomen. the abdomen is called an abscess. In this case, the priority is to make drainage under the guidance of ultrasound in combination with antibiotic treatment according to the protocol. Then an appointment for appendectomy after 6 months.
Therefore, the diagnosis of appendicitis must be made by an experienced gastroenterologist after performing the following methods:
– Clinical examination: including a thorough history, careful abdominal examination is necessary for a definitive diagnosis.
– Blood tests: help assess inflammation and infection to help support diagnosis and treatment
– Imaging: the patient may have x-ray, ultrasound or CT scan of the abdomen to help confirm the diagnosis of appendicitis as well as distinguish it from other causes of pain other than appendicitis. .
5. How to treat appendicitis?
The treatment for appendicitis is to remove the inflamed appendix. Appendectomy is the most common abdominal surgery. There are two common methods of appendectomy: laparoscopic appendectomy and open appendectomy.
– Laparoscopic appendectomy: an endoscope is inserted inside the abdomen to view and remove the appendix
– Open appendectomy: surgical removal of the appendix through an incision on the right side of the lower abdomen.
In addition, your doctor will prescribe antibiotics to treat infections, pain relievers, and possibly stool softeners. Usually after an appendectomy, the patient can go home right away. In case of rupture, the patient needs to stay in the hospital longer for the doctor to give antibiotics and monitor complications.
Laparoscopic appendectomy is the most common method in the treatment of appendicitis
6. Information you need to know after appendicitis surgery:
Recovery time after surgery depends on the method of laparoscopic or open surgery, appendicitis can be complicated or not. With uncomplicated appendicitis, laparoscopic surgery patients recover faster. You can usually be discharged from the hospital 1-2 days after surgery and quickly return to daily activities after 2-3 days. For cases of appendicitis with complications, the recovery time may be longer
6.1.Attention in daily life and medication
– Antibiotics and pain relievers can be used as prescribed by the doctor. Patients can use heating pads or ice packs over the incision to relieve pain.
– During the first week after surgery, the patient should exercise gently, do not lift heavy objects or participate in strenuous activities
– In case the appendix has not ruptured, the child can return to school 2-3 days after surgery. If the appendix has ruptured, the child can return to school 2 weeks after surgery. Most children can resume sports activities 1 week after surgery
– Clean the incision at home gently, the incision can be exposed to air to speed up the surface, avoid using powder or cream applied to the incision.
– Do not bathe in the bathtub, do not participate in water activities for 1 month until the incision is completely healed.
– Wear comfortable clothing and avoid tight clothing that can irritate the skin around the incision site.
– Protect your abdominal when coughing by placing a pillow in front of your abdominal, pressing it when coughing, laughing, or turning to relieve pain.
– Do not drive until your first post-operative visit.
– Can climb stairs, walk, … to exercise after surgery for acute appendicitis
– Talk to your doctor about when to have sex after surgery.
– The scar heals after 4-6 weeks and will soften and fade over time.
6.2.Attention in the diet
– After surgery, it is necessary to divide meals into several small portions during the day: 6-8 meals/day.
– Return to the old diet according to the doctor’s advice at an appropriate time.
– Drink plenty of water and non-caffeinated drinks, avoid fatty and greasy foods, etc. to avoid constipation after surgery.
Nutrition also needs to be paid attention to after appendicitis treatment
6.3 When should you contact your doctor?
Patients should consult their doctor when experiencing the following postoperative symptoms:
– Fever over 38 degrees Celsius, with or without cough. This is a warning sign of a lung infection or an infection in the abdomen.
– Heart rate rises above 100 beats/min.
– Chest pain, sudden shortness of breath
– More abdominal pain or discomfort.
– The incision is excessively red, swollen or oozing fluid.
– The incision is open
– Leg swelling and calf pain due to blood clots forming in the legs.
– Nausea, vomiting, chills, profuse sweating.
– Continuous diarrhea with fever (sign of intestinal infection).
– Constipation
– Inability to go to the bathroom or an empty bladder.
After surgery for acute appendicitis, patients need to be re-examined about 2 weeks after discharge
