Mataracy
VIP Contributor
This is a common surgical emergency which can occur at any age,but often affect young people .
The cause is either obstruction of the appendix by a faecolith (hard inspissated faecal pellet) or by infection of the lymphoid tissue under the mucosa.
SYMPTOMS AND SIGNS
The patient complains of abdominal pain which starts centrally and is colicky and then moves to the right iliac fossa and becomes more constant. Vomiting, nausea and loss of appetite are associated with the pain. Constipation is usually Present but occasionally there may be diarrhoea.
On examination, the tongue is usually furred and there are signs of mild dehydration. There is tenderness in the right iliac fossa. In late cases, a mass may be felt.
DIAGNOSIS
This is made on the symptoms and sign. X-trays and laboratory investigations are unhelpful.
TREATMENT
The treatment of appendicitis is appendicectomy,usually as soon as possible after the diagnosis has been made. However if a mass is present,conservative treatment may be commenced. The patient is forbidden anything by mouth. An intravenous infusion is instituted to replace lost fluid and antibiotics are given.if the patient responds and the mass reduces in size, oral fluid may be introduced over the next few days. The patient is discharged home once the mass has disappeared and appendicectomy is arranged in 2-3 months time. This is necessary to prevent reoccurrence.
The cause is either obstruction of the appendix by a faecolith (hard inspissated faecal pellet) or by infection of the lymphoid tissue under the mucosa.
SYMPTOMS AND SIGNS
The patient complains of abdominal pain which starts centrally and is colicky and then moves to the right iliac fossa and becomes more constant. Vomiting, nausea and loss of appetite are associated with the pain. Constipation is usually Present but occasionally there may be diarrhoea.
On examination, the tongue is usually furred and there are signs of mild dehydration. There is tenderness in the right iliac fossa. In late cases, a mass may be felt.
DIAGNOSIS
This is made on the symptoms and sign. X-trays and laboratory investigations are unhelpful.
TREATMENT
The treatment of appendicitis is appendicectomy,usually as soon as possible after the diagnosis has been made. However if a mass is present,conservative treatment may be commenced. The patient is forbidden anything by mouth. An intravenous infusion is instituted to replace lost fluid and antibiotics are given.if the patient responds and the mass reduces in size, oral fluid may be introduced over the next few days. The patient is discharged home once the mass has disappeared and appendicectomy is arranged in 2-3 months time. This is necessary to prevent reoccurrence.
