Acute Appendicitis

What Is Acute Appendicitis?

Sudden severe inflammation of the appendix is known as acute Appendicitis. This is a type of appendicitis, a condition in which the appendix become inflamed and swollen due to an abdominal infection.  It can occur in both children and adults. The disorder can turn life threatening if the infected appendix is not removed as soon as the symptoms occur.  The appendix can get ruptured within a few days or even hours in case of acute Appendicitis.

Acute Appendicitis Picture Acute Appendicitis

Acute Appendicitis Pathophysiology

The main factor responsible for this condition is a decreased blood flow to the appendix because of the blockage of its lumen. This obstruction is generally caused by some hardened fecal matter. The reduced blood supply due to the blockage makes the appendix vulnerable to the bacteria usually found in the intestines.

Acute Appendicitis Variations

It can be classified into three categories depending on the stage of severity of the disorder:

Sub-Acute Appendicitis: This is a less severe stage of Appendicitis. It is characterized by the normal symptoms of the condition, but they generally subside on their own before advancing to a severe stage.

Acute Suppurative Appendicitis: This is a form of acute Appendicitis in which purulent or suppurative exudate is present in the appendix wall and lumen. The lumen generally contains fecalith and pus which should be drained immediately to avoid perforation.

Acute Gangrenous Appendicitis: In this form of the disorder, necrosis (tissue death) occurs due to infection and the gangrenes or necrotic tissues remain within the inflamed appendix.

Acute Appendicitis Signs and Symptoms

The symptoms of this form of the illness generally occur suddenly, without any prior warning. The signs are similar to the common symptoms of Appendicitis, but are usually more intense compared to the latter. The characteristic symptoms include:

  • Acute pain in the lower right side of the abdomen where the appendix is located
  • Rebound tenderness in the area of illness (pain in the lower right abdominal region when the area is pressed and the pressure is suddenly released-the pain is greater when the pressure is released than when it applied)
  • Diarrhea
  • Constipation
  • Gas and bloating
  • Loss of appetite
  • Low fever with the temperature ranging from 99°C to 102° C
  • Vomiting
  • Nausea

This type of Appendicitis can turn fatal very quickly. Following are the symptoms that indicate the presence of some life threatening complication:

  • Change in consciousness and alertness
  • Dizziness
  • Cold and clammy skin
  • High fever
  • Rapid pulse
  • Hypotension

Acute Appendicitis Diagnosis

The basic diagnosis is usually made depending on the symptoms present in the patient. The diagnostician performs a physical examination and studies the symptoms to determine if the appendix of the patient in infected. Various diagnostic tests are used for confirming the diagnosis. Ultrasound examinations, CT scans and blood tests are most commonly used for this purpose.

It is important to rule out other similar conditions while performing the diagnosis. The differential diagnoses include various gastrointestinal, urological and gynecological disorders.

Acute Appendicitis Treatment and Management

In most cases, it is necessary to remove the inflamed appendix through surgery. The surgical procedure used for this purpose is known as appendectomy. The laparoscopic appendectomy is generally used for treating the condition. This is the least invasive method of removing the appendix. Sometimes the patient is treated using the more traditional open appendectomy surgery. The patient is given intravenous antibiotic doses so that the infection does not lead to peritonitis.

Acute Appendicitis Prognosis

The prognosis depends on a number of factors such as the age and overall health of the patients as well as the severity of the condition. At present, the outcome is positive in most cases with the patients attaining full recovery within a short period of time. However, the surgical removal of the appendix can lead to a number of serious complications.

Acute Appendicitis in Pregnancy

Appendicitis is one of the most common conditions that affect women during pregnancy and majority of these patients are diagnosed with the acute form of the disorder. It is very difficult to diagnose the inflamed appendix in pregnant women because of the physical changes that take place during this time. But, it is important to remove the infected appendix as soon as possible.

Acute Appendicitis is an emergency and potentially fatal disorder requiring prompt treatment to save the patient’s life. Proper treatment and follow up care is important to prevent the occurrence of perforated Appendicitis, which is a more serious condition.

References:

http://www.bmj.com/content/333/7567/530

http://www.patient.co.uk/doctor/Acute-Appendicitis.htm

http://www.localhealth.com/article/acute-appendicitis/symptoms

http://www.news-medical.net/health/What-is-Acute-Appendicitis.aspx

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