- 1. The appendix is located on the lower right side of the abdomen
- 2. The name "appendix" comes from the fact that parasites live in it
- 3. We can do without the appendix
- 4. Young children do not get appendicitis
- 5. Appendicitis may be the result of an inflammatory process elsewhere in the body
- 6. Inflammation manifests itself in the same way for everyone
- 7. If constipation occurs with appendicitis, do not take laxatives
- 8. To confirm the diagnosis, the doctor orders additional tests
- 9. The sick appendix is always removed
- 10. The appendixis removed only by the traditional technique, i.e. with the opening of the abdominal integuments
- 11. Pregnant women with appendicitis are not operated on
- 12. Antibiotics are required when appendix perforation and peritonitis are present
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We don't need the appendix, but it's good to have it. Inflammation or appendicitis manifests itself in the same way for everyone. It starts with abdominal pain and malaise. What do we really need to know about the appendix?
Many myths have arisen around the appendix. Some of them are true, of course, but not all. What is fact and what is myth?
1. The appendix is located on the lower right side of the abdomen
True, but …not all people have the appendix in the exact same place . This is where the problems with the correct diagnosis of appendicitis sometimes arise. It just hurts not where it should theoretically hurt.
The appendix is quite long (8-10 cm) but narrow (only 3-7 mm in diameter) andusually hangs freely within the right iliac fossa towards the pelvis . However, in some cases, the appendix may be shifted and may be hidden, for example, behind the caecum or behind the urinary bladder.
2. The name "appendix" comes from the fact that parasites live in it
Myth. An appendix is a longitudinal protrusion of the large intestine that grows from its initial part, called the cecum, below the mouth of the small intestine. It is filled with food debris or mucus, not worms. Sinceactually resembles a parasite attached to the intestine, it is called appendix .
3. We can do without the appendix
Fact. Until recently, the exact role of the appendix was not known. This is one of the reasons why in the USA this branch of the intestine was prophylactically excised, believing that it would prevent inflammation (because the appendix is small, it is easy to obstruct it, which is the basis of inflammation). It turned out, however, thatin the appendix has a highly developed lymphoid tissue that acts as a bacterial filter .
By cutting out the appendage prophylactically, the abdominal immune mechanisms were weakened. Fortunately, today no one removes the appendix just in case. However, if, for example, due to inflammation, it has to be cut out, the body functions completely normally after the surgery.
4. Young children do not get appendicitis
Myth.Appendicitis occurs at all ages , although it is actually most common between the ages of 10 and 30.
Rarely, but still, it becomes inflamed in children under 2 years of age. You have to remember thatappendicitis has a more severe course in children , therefore it is not necessary to delay the visit to the doctor.
5. Appendicitis may be the result of an inflammatory process elsewhere in the body
Fact.Infection can pass from other parts of the intestine or through blood from other organs.Most often, however, inflammation occurs when the appendix mechanically twists, swells significantly, is clogged with hard fecal masses or a foreign body (e.g. a swallowed small object).
6. Inflammation manifests itself in the same way for everyone
Myth.About 70 percent of patients have inflammation typically . It begins with malaise and pain in the area of the navel, in the epigastric region. The pain is rapidly increasing and is concentrated in the lower abdomen, on the right side. It worsens when coughing or moving, and softens when the patient is lying on his left side with his legs tucked up. After that, nausea, vomiting and temperature rises usually join. Diarrhea (more common in children) or constipation (more common in adults) may appear.
The doctor examining the patient presses the area of the right iliac fossa, because it is the most painful place in the case of appendicitis.In acute inflammation, it hurts more when the doctor takes his hands off his abdomen than when he puts pressure on him.He may also ask for the right leg to be lifted upright - the pain increases. In the case of an atypical location of the appendix - e.g. behind the bladder - ailments from the urinary system may predominate, e.g. pressure on the bladder, frequent urination.
7. If constipation occurs with appendicitis, do not take laxatives
True.They can cause the appendix to rupture during rapid bowel movements . You can take painkillers, although doctors advise against this as it is more difficult to diagnose when the medication relieves the pain.
8. To confirm the diagnosis, the doctor orders additional tests
Fact, but… If the symptoms are characteristic of appendicitis, the doctor does not have to order additional diagnostic tests. Sometimes, however, he or she orders a blood count (an increase in the number of white blood cells above normal, the so-called leukocytosis, is a confirmation of inflammation).
Sometimes it is also necessary to perform an X-ray of the abdominal cavity- if the doctor wants to exclude other acute diseases in the abdominal cavity, e.g. a rupturestomach ulcer. In some centers, an abdominal ultrasound is ordered because an experienced ultrasound scanner is able to distinguish between an inflamed appendix and a he althy appendix.
9. The sick appendix is always removed
Fact.There is no so-called chronic appendicitis , so either the patient has acute inflammation or his symptoms are not related to the appendix.
If the doctor suspects inflammation, he should refer the patient to the hospital, because this disease requires a quick operationof the so-called urgent indications.
Doctors divide appendicitis into five stages. The least dangerous stage is the first (the so-called catarrhal inflammation), and the most dangerous - the fifth (perforation, i.e. appendage perforation, with the leakage of fecal masses into the abdominal cavity and peritonitis). Starting from the third stage (so-called pyoderma), the patient's condition is so serious that he must be transported to the hospital for surgery as soon as possible.
10. The appendixis removed only by the traditional technique, i.e. with the opening of the abdominal integuments
Myth.If the inflammatory process is not too advanced(first, second stage of the disease),the doctor may decide to operate with the laparoscopic technique.However, it also happens that after inserting the tools into the abdominal cavity, it turns out that, for example, the condition of the appendix is more serious than it has been shown in previous studies and it may rupture (perforation). Then, during the procedure, the surgical technique is changed - laparoscopy is replaced by the traditional technique.
11. Pregnant women with appendicitis are not operated on
Myth. In pregnant women, the enlarging uterus causes the appendix to be moved upwards, and then pain may appear even in the area of the right hypochondrium, which may suggest, for example, acute cholecystitis. For this reason, it is more difficult to diagnose a pregnant woman.However, when the diagnosis is confirmed, surgeryis necessary (it is performed regardless of the stage of pregnancy), because the "spilling" of the appendix causes peritonitis that is dangerous for the woman and the fetus.
12. Antibiotics are required when appendix perforation and peritonitis are present
Fact. In addition, after the operation, a drain is left for some time to allow the discharge of secretions from the abdominal cavity. Usually, after a week, the patient recovers his strength, and after another week, he fully recovers.
It happens that as a result of appendicitis a peri-appendic infiltration occurs. Then the patientstays in the hospital for 2-3 weeks and is treated with antibiotics.But still, after the infiltration is absorbed, the appendix (as a source of infection) must be removed.