Acute appendicitis is the most common of all serious intestinal conditions. The appendix is a small tube about four inches long. It is located at the end of the cecum, or first part of the large bowel. However, this small pencil-sized tube may become badly inflamed due to a facelith or stone forming within it. This may then produce steno-sis or kinking of the appendix, followed by further inflammation and infection from certain germs usually present in the intestinal tract. This causes intense pain in the abdomen, usually on the right side, if the appendix is in the normal position.
Rapture Acute Appendicitis with Peritonitis.
If the inflammation continue to increase, the appendix may rapture, spreading the bowel contents all through the lower part of the abdomen – a serious state known as peritonitis. Loops of bowel may become adhered to each other, and the infected material may be walled off into a localized abscess close to the site of the perforated appendix.
Appendicitis usually begins by severe pain in the middle of the abdomen, followed by nausea, vomiting, and occasionally diarrhea. After several hours this pain seems to shift to the lower right side of the abdomen and is continuous, dull, and constant. Coughing and sneezing make the pain worse. The patient usually has a mild fever, less than 120º F., unless the appendix has raptures and the inflammation has spread. Sometimes the appendix is located in other areas of the abdomen, but most often it is down low on the right side.
Many other conditions. Among these are pancreatitis, regional enteritis, strangulated hernia, kidney stones, urinary infection, typhoid fever and even pneumonia. All of these must be considered in making the diagnosis of acute appendicitis.
Surgery is the only reliable method of treating acute appendicitis. It is far safer to take out a normal appendix than to run the risk of a raptures appendix followed bu widespread peritonitis. The patient should therefore be taken to hospital without delay and the appendix removed before it raptures, Meanwhile, keep and ice bag over the abdomen, give nothing by mouth except sips of water if the patient is very dry. Avoid laxatives, for this may rapture the appendix, For severe pain, give two aspirin tablets.
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