DEFINITION: Appendicitis is the inflammation of appendix.
CAUSES: – Block by faeces
– Intestinal worms
PATHOPHYSIOLOGY: Due to the above causes
Appendix become inflamed & edematous
Increase intraluminal pressure
Initiating progressive & severe pressure
Generalized upper abdominal pain
Inflamed appendix fill with pus
SIGNS AND SYMPTOMS:
• Abdominal pain, nausea, vomiting, and fever
• Lower abdomen (rebound tenderness)
• Coughing causes point tenderness in this area (McBurney’s point)
• Muscle spasm
Blood and urine test
• Computed tomography
• Magnetic resonance imaging
Acute appendicitis is typically managed by surgery. However, in uncomplicated cases antibiotics are both effective and safe. While antibiotics are effective for treating uncomplicated appendicitis, 20% of people had a recurrence within a year and required eventual appendectomy
Pain medications (such as morphine) do not appear to affect the accuracy of the clinical diagnosis of appendicitis and therefore should be given early in the person’s care.
The surgical procedure for the removal of the appendix is called an appendicectomy. Appendectomy can be performed through open or laparoscopic surgery. Laparoscopic appendectomy has several advantages over open appendectomy as an intervention for acute appendicitis.
The treatment begins by keeping the person who will be having surgery from eating or drinking for a given period of time, usually overnight. An intravenous drip is used to hydrate the person who will be having surgery. Antibiotics given intravenously such as cefuroxime and metronidazole may be administered early to help kill bacteria and thus reduce the spread of infection in the abdomen and postoperative complications in the abdomen or wound. If the stomach is empty (no food in the past six hours) general anaesthesia is usually used. Otherwise, spinal anaesthesia may be used.
• Place the patient in semi-fowler position.
• Start IV fluids
• Monitor carefully for signs of secondary haemorrhage
• Prevent infection at the surgical site