Appendicitis is the most common cause of abdominal pain requiring surgery, and more than 100,000 people in Korea undergo surgery for acute appendicitis every year.
Strictly speaking, appendicitis is not an accurate disease name, it is more correct to call it appendicitis.
The digestive system of our body consists of the mouth, where food is chewed and swallowed, through the esophagus, stomach, small intestine, and large intestine, and through the anus. 맹장염 자가진단
Among them, there is a digestive organ called the appendix in the part leading from the small intestine to the large intestine, and the small sac attached to the appendix is the appendix. 좋은뉴스
Appendicitis is a disease in which the appendix, a small organ attached to the appendix, becomes inflamed, so it is medically correct to call it acute appendicitis rather than appendicitis.
The clinical picture of acute appendicitis varies depending on whether or not there is a perforation.
If there is no perforation, digestive system symptoms including indigestion, abdominal pain in the right lower part, mild fever, etc. will be seen.
However, in the case of perforation, a mass caused by an abscess around the appendix may be palpable or appear in the form of peritonitis.
In the case of acute appendicitis, if not treated, symptoms such as perappendical abscess or perforation may occur.
Therefore, until now, when acute appendicitis is diagnosed, prompt surgical treatment is the best method.
What causes appendicitis?
Basically, acute appendicitis begins when the inside of the appendix becomes blocked, from whatever cause.
When the appendix is blocked, the normal movement of the intestine from the appendix to the large intestine is restricted.
Because of the lack of movement, intestinal bacteria multiply and secrete toxic substances.
These substances then damage the mucous membrane inside the appendix and form an ulcer.
In adults, small fecal masses block the entrance and become inflamed.
Who gets appendicitis?
Acute appendicitis often occurs in young people between the ages of 10 and 20, and is most common in the early 20s.
Appendicitis patients before the age of 10 or after the age of 50 account for about 10% of all appendicitis patients.
Most patients seek medical care within 12 to 18 hours of symptom onset.
Symptoms of appendicitis can be vague.
In about half of all patients, the disease progresses with typical clinical features, so doctors can easily diagnose it with a simple examination.
However, non-specific symptoms are not easily diagnosed, so it is common to undergo surgery after progressing to peritonitis.
It is relatively typical in the younger age group.
In addition, in the early stages of the disease, when drugs such as antibiotics or painkillers are taken, the pain is masked and it often progresses to a per-appendical abscess.
In these cases, diagnosis is more difficult.
What are the early symptoms of appendicitis?
At the onset of the disease, appetite is lost, nausea first sets in, followed by epigastric pain.
At this time, vomiting may occur once or twice, and there is no abnormality in the right lower abdomen where the appendix is located, or only slight tenderness appears during examination.
Therefore, at this time, it is easy to think that even in the House of Representatives, it was just an act.
Epigastric pain passes around the navel and changes to right lower abdominal pain over time.
When examined at this time, tenderness is evident in the right lower abdomen, and a feeling of pain appears when pressing and releasing.
A slight fever gradually begins to appear, and you may feel chills.
What are the symptoms of appendicitis as it progresses?
If appendicitis is perforated, the pain becomes more severe and the painful area is not limited to the right lower abdomen, but spreads to the entire lower abdomen or the entire abdomen.
The fever rises and the heart rate quickens.
The symptoms mentioned above are typical, but there are also cases where they are not and start with symptoms that are far from appendicitis at all.
Therefore, the symptoms of acute appendicitis are very diverse.
Because of this, the symptoms are not particularly evident, so I thought I was just sick and endured the pain, and eventually the appendix burst, resulting in perforated peritonitis, and then I was taken to the emergency room.
Patients with vague symptoms like this account for a third of the total, and according to the Journal of the American College of Surgery, up to 16% of patients undergo surgery because of these vague symptoms.
How to self-diagnose appendicitis?
Many people are very aware of the diagnosis of appendicitis, but it is often not the case.
If you visit a hospital with typical symptoms, most medical staff will easily suspect appendicitis.
However, it is not easy to suspect appendicitis if you complain of non-specific symptoms.
When diagnosing acute appendicitis, the most important thing is whether or not there is pain when the part where the appendix is located is pressed.
This area is called the ‘McBurney Point’, and the exact location is the outer third of the imaginary line connecting the navel and the bone protruding from the front of the pelvis.
If I go to the hospital for appendicitis, what tests will I be given?
It can be diagnosed by abdominal pain, right lower abdomen, especially the presence or absence of tenderness at McBurney’s point, low-grade fever, and increased white blood cells, along with symptoms like feeling sick.
However, when the symptoms are ambiguous or the diagnosis is ambiguous, it is difficult to conclude with simple examination and blood test findings, so computed tomography or ultrasound is used to increase the diagnosis rate.
However, there are cases where it is difficult to make a 100% diagnosis through these imaging diagnoses before surgery.
Therefore, if there is insufficient evidence for appendicitis in the preoperative examination, the patient may be hospitalized and monitored.
Appendicitis treatment and surgery?
Surgery is the standard treatment for acute appendicitis.
Usually, surgery for acute appendicitis is recognized as a minor operation by the general public, but if the symptoms of acute appendicitis are severe, the surgical site may enlarge and the operation may become complicated.
The appendix usually ruptures if surgery is not performed within 3 days of the onset of symptoms. Then, it develops into an abscess in which pus collects around the ruptured appendix, resulting in peritonitis in which pus spreads throughout the abdominal cavity.
When peritonitis occurs and surgery is performed, not only the size of the operation increases, but also the recovery period becomes longer, and complications such as sepsis and intestinal adhesions may occur after surgery.
Recently, in some cases, laparoscopic surgery is performed for quick recovery with small surgical scars.
However, laparoscopic surgery may be difficult in the case of advanced tissue damage around the appendix or perforated appendicitis accompanied by peritonitis.
What are the complications after appendicitis surgery?
Most complications after appendectomy are infections.
Complications occur in only 5% of cases of appendicitis, but in the presence of tissue necrosis or perforation, the complication rate may reach 30%.
The rate of skin infection at the surgical site of simple appendicitis without perforation is 4-8%, and the incidence of re-abscess in the abdominal cavity after surgery is less than 1%, so there are not many complications.
However, when there is perforation or tissue necrosis, skin infection at the surgical site occurs in 10-20%, and abscess often occurs in the abdominal cavity again after surgery.
What are the characteristics of appendicitis in children and the elderly?
appendicitis in children
In the early days, children keep getting drowsy, showing irritability and anorexia, and progressing quickly, resulting in vomiting, fever, and pain in the early stages.
appendicitis in the elderly
Appendicitis in the elderly often has no typical symptoms, progresses quickly, and complications are common.
Symptoms and examination findings of acute appendicitis do not reflect inflammation well, and the degree of tenderness and abdominal pain is not the same as that of young people, so diagnosis is delayed, and surgery is often performed only after perforating peritonitis or peri-appendical abscess.
In the case of the elderly, it is often diagnosed late because it is difficult to express due to various factors, so sudden indigestion or abdominal pain should not be overlooked too much.