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Appendicitis

How do you know that you have appendicitis? Often it presents with pain in the right lower abdominal quadrant. This pain can be accompanied with or without rebound tenderness at first. When the appendix is inflamed, other symptoms soon follow: nausea, vomiting, fever and loss of appetite.

Seeing a doctor is the way that appendicitis is confirmed and treatment is decided. Unless you have a mild case (confirmed by diagnostic testing), surgery is usually indicated to resolve the problem. Since the appendix is not needed for anything, taking it out won’t impair the functioning of any system.

When surgery is indicated, your doctor will talk to you about how it all works. They will discuss the surgical procedure with you. For years, appendectomy (removal of the appendix) was performed through a vertical incision called a McBurney’s incision. Now, there is a way that the appendix can be removed laparoscopically (through a small port using a scope and a camera). The latter means faster healing time and less pain on average.

Before your surgery date, your doctor will send you for a pre-operative meeting at the hospital. Here, they will check your vitals and do blood work ordered by your physician. In the event of an active infection, the doctor may prescribe antibiotics leading up to the surgery date. After, you will receive instructions for how to prepare for the big day.

Appendectomy requires general anesthesia. This means that you will be unconscious using anesthetic agents and an endotracheal tube to maintain your airway on a ventilator. The anesthesiologist will interview you and ask if you have any adverse effects to anesthetic agents that you know of. This helps them to choose the right cocktail of drugs for your surgery.

During the surgery, the doctor will make an incision, a couple of inches long, over the site of the appendix. The muscles and tissue of the area are opened and the appendix is located at the end of the cecum (large intestine). It is examined and pulled through the opening in your skin.

The small organ is tied off with suture or a stapler to separate it from the bowel, but leaving a tight seal so that no bowel contents can spill out into the abdomen. The bowel is examined for signs of inflammation. The entire area is washed with saline to remove any pus that may have entered the abdominal cavity. The layers of tissue are sutured closed.

After surgery, your doctor might keep you in the hospital for observation to be sure that the bowel has no leaks and begins to heal properly. He will also tell you how to care for your incision and what activities to avoid as you heal.

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