CLINACASE

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Category: General
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createdon: 30 Mar 2023
updatedon: 06 Apr 2023

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Author: Khoa Tran
Published Mar 30, 2023
Updated Apr 06, 2023

Table of contents

Appendicitis

Etymology and Pronunciation

Appendicitis (uh-pen-duh-SAHY-tis)
appendere - Latin for "to hang something on"
-itis - Greek for "inflammation"

History of Appendicitis

Appendicitis is a medical condition characterized by inflammation of the appendix, a small, finger-like organ attached to the large intestine. The condition can be caused by a variety of factors, including blockage of the appendix by fecal matter or other materials, infection, or inflammation.

The first recorded case of appendicitis was described by the Roman physician Aulus Cornelius Celsus in the 1st century AD, who recommended surgery to remove the inflamed appendix. In "De Medicina" Celsus describes the symptoms of appendicitis, which he called "inflammation of the cecum" and recommends surgical removal of the inflamed organ. He notes that the condition is often fatal, and that prompt surgical intervention is necessary to prevent complications and death. Surgical procedures during this time were typically performed using a variety of basic surgical tools, such as knives, hooks, and probes. Without the use of modern anesthesia, surgical procedures were likely painful and traumatic for the patient. In some cases, patients were given herbal remedies or alcohol to help numb the pain, but these treatments were often ineffective and sometimes harmful.

In the 18th and 19th centuries, appendicitis was still a poorly understood condition, and many doctors believed that it was caused by a buildup of gas in the appendix. However, in 1886, the American surgeon Reginald Fitz published a paper describing the true nature of the condition and its causes.

Fitz's paper, entitled "Perforating Inflammation of the Vermiform Appendix" described the symptoms, pathology, and treatment of appendicitis in detail. He recognized that the condition was caused by blockage of the appendix, leading to inflammation and infection.

Fitz's work was a major breakthrough in the understanding and treatment of appendicitis. His paper helped establish the diagnosis and treatment of appendicitis as a distinct medical specialty, and led to the development of surgical techniques to remove the inflamed appendix.

Modern Understanding of Appendicitis

Appendicitis is a medical condition that involves inflammation of the appendix, which is a small, finger-shaped organ attached to the large intestine. This condition can affect people of any age, but it is most common in teenagers and young adults.

The symptoms of appendicitis can vary, but some common ones include abdominal pain, nausea, vomiting, and fever. The pain usually starts in the middle of the abdomen and then moves to the lower right side, where the appendix is located. The pain may worsen with movement, coughing, or deep breathing. Other symptoms may include loss of appetite, constipation, or diarrhea.

Appendicitis is caused by blockage of the appendix, usually by fecal matter, foreign bodies, or enlarged lymphoid tissue. When the appendix becomes blocked, bacteria can grow and multiply inside, leading to inflammation and infection.

If left untreated, appendicitis can cause the appendix to rupture, leading to serious complications such as peritonitis, abscess formation, and sepsis. Therefore, it is important to seek medical attention promptly if you suspect you have appendicitis.

Causes of Appendicitis

The exact cause of appendicitis is not always clear, but there are a few known factors that can contribute to its development:

- Obstruction: A blockage in the lining of the appendix can lead to an accumulation of mucus, bacteria, and other substances, which can cause the appendix to become inflamed and infected.
- Infection: Sometimes, an infection elsewhere in the body can spread to the appendix and cause inflammation.
- Trauma: Injury or trauma to the abdomen can cause inflammation of the appendix.
- Enlarged tissue: Enlarged lymphatic tissue in the wall of the appendix can obstruct the opening of the appendix and lead to inflammation.
- Parasites: Certain parasitic infections can cause appendicitis.

In many cases, the exact cause of appendicitis remains unknown. It can occur at any age, but is more common in children and young adults. If left untreated, appendicitis can lead to serious complications, such as rupture of the appendix and the spread of infection to the abdominal cavity.

Treatments for Appendicitis

The primary treatment for appendicitis is the removal of the appendix, which is known as an appendectomy. This is usually done through surgery and can be performed laparoscopically or through open surgery, depending on the severity of the condition and the preference of the surgeon.

In cases where the appendix has not yet ruptured, the surgery can typically be performed as soon as the diagnosis is confirmed. In cases where the appendix has already ruptured or an abscess has formed, the patient may need to receive antibiotics before surgery to help control the infection.

Pain management is also an important part of the treatment plan for appendicitis. Pain relievers, such as acetaminophen or ibuprofen, may be used to help manage the pain. However, it's important to avoid taking aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs), as these can increase the risk of bleeding.

In some cases, appendicitis may be managed with antibiotics alone, particularly in patients who are unable to undergo surgery due to other medical conditions. However, this approach is typically only used in milder cases of appendicitis and may not be appropriate for everyone.

Symptoms

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Extreme pain in the navel (belly button) area and then moves to the lower right side of the abdomen
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Rigid abdominal muscles
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Abdominal pain
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Abdominal tenderness
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Loss of appetite
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Diarrhea

Confirmation Tests

- Blood test
- Urinalysis
- X-rays
- Ultrasound
- CT scan
- MRI

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