Appendicitis - Diagnosis and Testing - Case Study Example

Appendicitis An Assignment Submitted by Fall Appendicitis Introduction Appendix is a small tubular structure attached to the large intestine of a human body (“Appendicitis,” 2014). Though its function is not well defined yet, it is crucial for human existence and malfunctioning of it could lead to threatening consequences. That is, the appendix sometimes inflames and the resulting condition is termed as appendicitis, which is a medical emergency (“Appendicitis,” 2014). Here, the focus is on the symptoms and causes of appendix, its diagnosis, testing methods, potential outcome of the disease, and its possible treatment methodologies. Signs and Symptoms Appendicitis causes a series of symptoms in a patient, out of which the primary symptom is an acute radiating pain that extends from the naval towards the right side of the lower abdomen. This severity of the pain may worsen when the patient coughs or makes some sharp movements. The other symptoms are vomiting accompanied with high fever. The abdomen gets bloated and sometimes constipation or diarrhoea may occur (Karriem-Norwood, 2014). Patient with the above symptoms must get immediate medical attention as appendicitis when not treated in a timely manner may be fatal. Causes When the lumen (inner wall of the appendix) gets obstructed, inflammation of the appendix occurs. This obstruction may occur due to some bacterial infection, cancer, or faecal matter. As a result, the appendix gets filled with puss cells that swell and create pressure within the inner wall of the appendix. This pressure may cause blood clot within the blood vessels and make the lymphatic vessels which carry lymph to the heart becomes inactive (“Appendicitis,” 2014). Appendicitis - Diagnosis and Testing The symptoms of appendicitis may be misleading because other diseases like urinary infection, gall bladder infection, intestinal infection, gastritis and gynaecological problems may also result in extremely similar signs and symptoms of appendicitis (Marks, 2014). Careful and timely diagnosis is very important. Thorough investigation of patient history and physical examination may sort out the problem. The doctor may physically examine the patient by applying gentle pressure on the painful region of the abdomen which will worsen the pain as a sign of infection in the peritoneum (tissue that builds the inner wall of the abdomen and supports most of the organs in the abdomen) (“Diseases and Conditions – Appendicitis,” 2014). Blood test may be taken to examine the level of White Blood Corpuscles (WBC) in the blood. Whenever there is an infection in any part of the human body, the WBC in the blood multiplies in large amounts to fight the infection. Thus elevated WBC count in the body indicates some infection and this might not be necessarily appendicitis. So, to further confirm appendicitis, other tests are required (Marks, 2014). Next to rule out a urinary tract infection or kidney stone problems, urinalysis is done. This detects the count of Red Blood Cells, WBC, and bacteria in the urine. In most cases a normal urinalysis report indicates that the severe abdominal pain is due to appendicitis and not urinary tract infection. (“Diseases and Conditions – Appendicitis,” 2014) X-ray of the abdomen may be taken which can clearly indicate any obstruction in the appendix. Ultra sound scan may be helpful in spotting the inflamed appendix. But in most cases, even ultra sound scan does not clearly show the presence of appendicitis. On the other hand, an ultra sound scan may be useful in case of a female patient because it can clarify whether the pain is due to appendicitis or other gynaecological problems (Marks, 2014). A Computerised Tomography (CT) scan can accurately diagnose the inflammation of appendix and excludes all other abdominal disease that may mimic appendicitis (Marks, 2014). Potential outcome of the disease Appendicitis may lead to blockage of blood vessels. Eventually blood supply to the tissues in the body gets restricted, preventing oxygen and glucose reaching the cells which is inevitable for cellular metabolism. As a result premature death of cells in a living tissue occurs. If left untreated, the appendix ruptures and leads to fatal consequences. When appendix bursts, abscesses (painful collection of pus) form around the ruptured appendix due to bacterial infection (Marks, 2014). In most cases, a ruptured appendix leads to peritonitis. Peritonitis is a condition where the peritoneum gets inflamed due to bacterial or fungal infection. (“Appendicitis,” 2014). Peritonitis subsequently spreads the infection into the blood stream thus spreading the infected blood to almost all parts of the body. This condition may lead to multiple organ failure and ultimately death. Treatment In cases where severity of the appendicitis is less, the patients can be treated with antibiotics to control infection and surgery may not be required. But, in many cases there is a strong possibility of reoccurrence of the disease. So, surgical removal of the inflamed appendix is the best way to treat appendicitis. This procedure is termed as appendectomy (Ben-Joseph, 2013). The surgery can be done in either of the two ways laparotomy or laparoscopic. In laparotomy, a 2-3 inches incision is made in the lower right abdomen after giving general anaesthesia to the patient. The surgeon spots the infected tissues, removes, and cuts the appendix from the surrounding tissues. After careful examination for any infections, the surgeon sews the muscles to close up the skin. Laparoscopic surgery is an advanced form of the above surgery in which 3 – 4 incisions each about 0.25 to 0.5 inches are made on the abdominal area (Ben-Joseph, 2013). Laparoscope which connects to the monitor helps the surgeon to inspect the infected area. Through the other two incisions surgical instruments are inserted for the removal of appendix (“Surgery and Procedures,” n.d). If abscesses present if any, must be drained carefully to avoid further spread of infection. The patient needs a stay in the hospital which may vary from few hours to few days, depending on the severity of his/her condition. Some complementary medications may be prescribed by the doctor to control pain after appendectomy. Conclusion Though there are no preventive measures to prevent appendicitis, its occurrence is less common in people who practice a healthy diet chart which includes a lot of fibre rich food like fresh fruits and vegetables. So, healthy eating habits can reduce the chances of appendicitis. If at all one have to encounter appendicitis, accurate and speedy diagnosis with apt medical treatment can aid the affected in overcoming the disease, which may otherwise be lethal. Works Cited Appendicitis. (2014, August 9). In U.S. National Library of Medicine. Retrieved from http://www.nlm.nih.gov/medlineplus/appendicitis.html Ben-Joseph, E. P. (2013, March). Surgery and Procedures: Appendectomy. Retrieved from http://kidshealth.org/parent/system/surgery/ appendectomy.html# Diseases and conditions – appendicitis. (2014, August 20). In Mayo Clinic. Retrieved from http://www.mayoclinic.org/diseasesconditions/appendicitis/ basics/definition/con-20023582 Karriem-Norwood, V. (2013, August 30). Appendicitis. Retrieved from http://www.webmd.com/digestive-disorders/digestive-diseases-appendicitis Marks, J. W. (2014, October 2). Appendicitis. Retrieved from http://www.medicinenet.com/appendicitis/article.htm Read More