Appendicitis Health Article

Treatment

The treatment for appendicitis is an immediate appendectomy, which is done by opening the abdomen in the standard open appendectomy technique, or through laparoscopy. In laparoscopy, a smaller incision is made beside the navel. Both methods can successfully accomplish the removal of an appendix. It is not certain that laparoscopy holds any advantage over open appendectomy. When an appendix has ruptured, patients undergoing a laparoscopic appendectomy may have to be switched to the open appendectomy procedure for successful management of the rupture. If a ruptured appendix is left untreated, the condition is fatal.

Prognosis

Appendicitis is usually treated successfully by appendectomy. Unless there are complications, people usually recover without further problems. The mortality rate in cases without complications is less than 0.1%. When an appendix has ruptured, or a severe infection has developed, the likelihood for complications is higher, with slower recovery, or death from disease. There are higher rates of perforation and mortality among children and elderly persons.

Health care team roles

A physician, physician assistant, or nurse practitioner usually makes an initial diagnosis of appendicitis based on history, physical findings, and laboratory results. A laboratory technician may provide a test that confirms a diagnosis. A surgeon removes an appendix. Nurses assist by collecting data from the patient and family, monitoring vital signs and status of pain, and providing patient education about the diagnosis, surgery, and recovery.

Prevention

Appendicitis is probably not preventable, although there is some indication that a diet high in green vegetables and tomatoes may help prevent appendicitis.

KEY TERMS

Appendectomy—Surgical removal of the appendix.

Appendix—The worm-shaped pouch attached to the cecum, the beginning of the large intestine.

Laparotomy—A surgical incision into the abdomen, made between the ribs and the pelvis, that offers surgeons a view inside the abdominal cavity.

Peritonitis—Inflammation of the peritoneum, membranes lining the abdominal pelvic wall.

Ulceration—An abnormal change in tissue accompanied by the death of cells.

BOOKS

Carter, David C. "The Acute Abdomen." In Diseases of the Gastrointestinal Tract and Liver, edited by David J.C. Shearman et al. New York: Churchill Livingstone, 1997.

Hartman, Gary E. "Acute Appendicitis." In Nelson Textbook of Pediatrics, 16th ed., edited by Richard E. Behrman et al. Philadelphia: Saunders, 2000, 1178-81.

Krahenbuhl, L. Acute Appendicitis: Standard Treatment and the Role of Laparoscopic Surgery. Basel, Switzerland: Karger Publishing, 1998.

Silen, William. "Acute Appendicitis." In Harrison's Principles of Internal Medicine, 14th ed., edited by Anthony S. Fauci et al. New York: McGraw-Hill, 1998, 1658-59.

PERIODICALS

Bachoo, P., A. A. Mahomed, G. K. Ninan, and G. G. Youngson. "Acute Appendicitis: The Continuing Role for Active Observation." Pediatric Surgery International 17 no. 2-3 (2001): 125-28.

Gronroos, J. M., and P. Gronroos. "Diagnosis of Acute Appendicitis." Radiology 219 no. 1 (2001): 297-98.

Jones, P. F. "Computed Tomography in Suspected Acute Appendicitis." Surgery 129 no. 4 (2001): 514-15.

Van Der Meer, Antonia. "Do You Know the Warning Signs of Appendicitis?" Parents Magazine (April 1997): 49.

ORGANIZATIONS

American College of Gastroenterology. 4900 B South 31st Street, Arlington VA 22206. (703) 820-7400. (703) 931-4520. <http://www.acg.gi.org>.

American College of Surgeons. 633 North St. Clair Street, Chicago, IL 60611. (312) 202-5000. (312) 202-5001. <http://www.facs.org>stmaster@facs.org.

OTHER

American Academy of Family Physicians. <http://www.aafp.org/afp/991101ap/2027.html>.

Dr. Koop.com. <http://www.drkoop.com/conditions/ency/article/000256.htm>.

Harvard University and Brigham Hospital. <http://www.brighamrad.harvard.edu/Cases/bwh/hcache/112/full.html>.

National Digestive Diseases Information Clearinghouse. <http://www.niddk.nih.gov/health/digest/summary/append/>.

National Library of Medicine. <http://www.nlm.nih.gov/medlineplus/appendicitis.html>.

L. Fleming Fallon, Jr., M.D., Dr.P.H.