This lesson will discuss a famous condition called appendicitis. It will describe for you the potential causes of this condition, whom it’s most likely to affect, and which clinical signs and symptoms to look out for.
An Emergency Condition of the Young
Most often, we tend to think that some sort of problem, like a broken bone or a disease, is associated with the elderly. Stereotypically, this is very true. As you age, there are so many things that ‘go wrong,’ in a manner of speaking, within your body that the risk of disease or trauma is higher in older individuals.
Of course, that’s just a stereotype, nothing more. This lesson will point out one condition that disproves this stereotype in a big way since it’s an emergency condition most often associated with young people.
What Is Appendicitis?
I would be willing to bet some money on the fact that you’ve already heard of appendicitis, the acute inflammation of the appendix. Maybe you’ve had it yourself, or you know of someone close to you that has.
Although still in question, it is believed by some that the appendix is nothing more than a vestigial remnant. This means that it is a structure that long ago, in our evolutionary past, had served an important purpose but, due to changing environmental and genetic conditions, is no longer significantly useful.
It’s kind of like people who are born with tails. I think you’ll agree with me that there’s really no use for a tail in a modern Homo sapien, so it’s a vestigial remnant of our evolutionary past that sometimes remains after improper embryological development.
Be that as it may, appendicitis is still a serious condition even if the appendix has no significant role in our body. It’s the most common abdominal medical emergency and typically affects people between the ages of 10 and 30.
Why Does Appendicitis Occur?
There are several proposed reasons for why appendicitis occurs. These have to do with obstruction, infection, and inflammation. Many times it’s a combination of them.
An obstruction of the appendix can occur due to:
- A fecalith, a hard mass of feces. The suffix ‘-lith’ refers to a stone due to its hard consistency or stone-like shape. This is more common in adults and elderly individuals.
- Foreign material from things like fruit seeds or a parasitic worm infestation.
- Neoplasia – that is to say a tumor – also something usually not associated with young patients since tumors take a long time to develop.
With respect to inflammation, inflammation leading to appendicitis can be a result of inflammatory bowel disease or infection (which is the more common cause of appendicitis in children and teens).
What you need to know is that the appendix is rich in lymphoid tissue. Lymphoid tissue is a collection of cells and organs responsible for the defense of our body against pathogens. This tissue swells, or undergoes hyperplasia, during inflammation or infection as the cells within it multiply in order to increase their numbers so that they can put up a good fight against the pathogen. This swelling can, in turn, lead to obstruction of the appendix.
Regardless of the cause, the end result is the inflammation of the appendix, aka appendicitis. The inflammation, obstruction, swelling, and intestinal bacterial multiplication within the appendix all contribute to the infection, death, and weakening of the wall of the appendix. If the wall weakens enough, the appendix will burst, and this can result in a painful death if left untreated.
Signs, Symptoms ; Diagnostics
In order to try and prevent death from appendicitis, it’s important to recognize the clinical signs and symptoms of a possible problem. Remember, a clinical symptom is subjective in nature, like a complaint that something hurts. In contrast, a clinical sign is objective in nature, such as a measurement of someone’s temperature with a thermometer, possibly indicating a fever.
Patients with appendicitis may present with one, or a combination, of the following:
- A large proportion of time, patients will initially have periumbilical (around the navel) or epigastric (centrally in the upper abdomen) pain that progresses to the right-lower quadrant in 12 to 18 hours’ time.
- Other patients may simply present with right-lower quadrant pain straight off the bat.
- Rovsing’s sign, a sign indicating the potential presence of appendicitis might be present. This sign is elicited when palpation of the left-lower quadrant causes or increases the pain in the right-lower quadrant. Palpation is the use of hands and fingers to feel an area of the body.
- Nausea, vomiting, and anorexia
Laboratory tests will reveal leukocytosis with a left shift, indicating infection. Leukocytosis is an abnormal increase in the amount of white blood cells in the blood, and a left shift means that an unusually high number of immature white blood cells have been released into circulation. That’s because the body is desperate to fight off the infection and releases immature white blood cells to help fight the disease alongside the mature white blood cells. It’s an act of rightful desperation, in a sense, by your body. It gets anyone who’s barely old enough to go join the fight so you can survive.
If the leukocytosis is unusually high, it may be indicative of perforation. Furthermore, a CT scan or ultrasound may help confirm the diagnosis of appendicitis.
Treatment of Appendicitis
Once diagnosed, the only treatment for appendicitis is antibiotics to help fight the infection alongside an appendectomy, the removal of the appendix out of the body, via one of two surgical approaches. The two main surgical options include an open appendectomy, where an abdominal incision is made to take out the appendix, or a laparoscopic appendectomy, where a few small incisions are made in order to pass instruments into the abdomen that help visualize and remove the appendix.
Since appendicitis is so common and famous, I think it’s only fair we go over the critical things we discussed.
Appendicitis is the acute inflammation of the appendix.
There are several proposed reasons for why appendicitis occurs, including as a result of a fecalith, a hard mass of feces, or as a result of inflammation and infection leading to hyperplasia of lymphoid tissue, a collection of cells and organs responsible for the defense of our body against pathogens.
People with appendicitis may exhibit Rovsing’s sign, a sign indicating the potential presence of appendicitis. This sign is elicited when palpation of the left-lower quadrant causes or increases the pain in the right-lower quadrant. Palpation is the use of hands and fingers to feel an area of the body.
Other than pain in the right-lower quadrant of the abdomen, laboratory tests will reveal leukocytosis with a left shift, indicating infection. Leukocytosis is an abnormal increase in the amount of white blood cells in the blood in individuals with appendicitis.
Once diagnosed, the only treatment for appendicitis is antibiotics to help fight the infection alongside an appendectomy, the removal of the appendix out of the body, via an open or laparoscopic appendectomy.
By completing this video lesson, you could become better equipped to:
- Characterize appendicitis
- List the three main causes of obstruction in the appendix
- Recall the main indicators of appendicitis
- Point out the treatment for appendicitis
- Evaluate the two possible procedures for an appendectomy