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Appendicitis (or epityphlitis) is a condition characterized by inflammation of the appendix. All cases require removal of the inflamed appendix, either by laparotomy or laparoscopy. Untreated, mortality is high, mainly due to peritonitis and shock.[1] Reginald Fitz first described acute appendicitis in 1886,[2] and it has been recognized as one of the most common causes of acute abdomen pain worldwide.
Causes of Appendicitis
The cause of appendicitis relates to blockage of the inside of the appendix, known as the lumen. The blockage leads to increased pressure, impaired blood flow, and inflammation. If the blockage is not treated, gangrene and rupture (breaking or tearing) of the appendix can result.
An obstruction. Food waste or a hard piece of stool (fecal stone) can become trapped in an orifice of the cavity that runs the length of your appendix.
An infection. Appendicitis may also follow an infection, such as a gastrointestinal viral infection, or it may result from other types of inflammation.
Symptoms of Appendicitis
The symptoms of appendicitis vary. It can be hard to diagnose appendicitis in young children, the elderly, and women of childbearing age.
Typically, the first symptom is pain around your belly button. (See: abdominal pain.) The pain may be vague at first, but becomes increasingly sharp and severe. You may have reduced appetite, nausea, vomiting, and a low-grade fever.
The symptoms of appendicitis can vary according to a child’s age. In kids 2 years old or younger, the most common symptoms are vomiting and a bloated or swollen abdomen, accompanied by pain.
Early symptoms are often hard to separate from other conditions including gastroenteritis (an inflammation of the stomach and intestines). Many people admitted to the hospital for suspected appendicitis leave the hospital with a diagnosis of gastroenteritis; true appendicitis is often mis-diagnosed as gastroenteritis initially.
Treatment of Appendicitis
The surgery that corrects appendicitis, called an appendectomy, is a procedure with relatively little risk. Normally, the patient stays in the hospital for less than a week and can usually count on being back to a normal routine in three weeks. Many surgeons are performing laparoscopic appendectomy in which the appendix is removed through three small incisions (less than half an inch long) using special instruments and a special camera. With laparoscopic appendectomy, most patients can go home within 24 hours of the operation.
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