Appendicitis (cont.)
What are the complications of appendectomy?
The most common complication of appendectomy is infection
of the wound, that is, of the surgical incision. Such infections vary in
severity from mild, with only redness and perhaps some tenderness over the
incision, to moderate, requiring only antibiotics, to severe, requiring
antibiotics and surgical treatment. Occasionally, the inflammation and infection
of appendicitis are so severe that the surgeon will not close the incision at
the end of the surgery because of concern that the wound is already infected.
Instead, the surgical closing is postponed for several days to allow the
infection to subside with antibiotic therapy and make it less likely for
infection to occur within the incision. Wound infections are less common
with laparoscopic surgery.
Another complication of appendectomy is an abscess, a collection of pus in
the area of the appendix. Although abscesses can be drained of their pus
surgically, there are also non-surgical techniques, as previously discussed.
Are there long-term consequences of appendectomy?
It is not clear if the appendix has an important role in the body in older
children and adults. There are no major, long-term health problems resulting
from removing the appendix although a slight increase in some diseases has been
noted, for example, Crohn's disease.
What is new about appendicitis?
Recently it has been hypothesized that some episodes of appendicitis-like
symptoms, especially recurrent symptoms, may be due to an increased sensitivity
of the intestine and appendix from a prior episode of
inflammation. That is, the recurrent symptoms are not due to recurrent
episodes of inflammation. Rather, prior inflammation has made the nerves
of the intestines and appendix or the central nervous system that innervate them
more sensitive to normal stimuli, that is, with stimuli other than
inflammation. This will be a difficult, if not impossible, hypothesis to
confirm.
- The appendix is a small, worm-like appendage attached
to the colon.
- Appendicitis occurs when bacteria invade and infect
the wall of the appendix.
- The most common complications of appendicitis are
abscess and peritonitis.
- The most common manifestations of appendicitis are pain, fever, and abdominal
tenderness.
- Appendicitis usually is suspected on the basis of a
patient's history and physical examination; however, a white blood cell count,
urinalysis, abdominal x-ray, barium enema, ultrasonography, CT, and
laparoscopy also may be helpful in diagnosis.
- Due to the varying size and location of the appendix
and the proximity of other organs to the appendix, it may be difficult to
differentiate appendicitis from other abdominal and pelvic diseases.
- The treatment for appendicitis usually is antibiotics
and appendectomy (surgery to remove the appendix).
- Complications of appendectomy include wound infection and abscess.
Last Editorial Review: 12/7/2007
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