Appendectomy: It is the surgical removal of the vermiform appendix.
The word appendectomy can be divided into two parts. The first part of the word, “Append” refers to the greek root appendix, and the suffix “-ectomy” means removal or excision.
The Appendix usually lies at the right iliac fossa, the right lowermost outermost quadrant of the abdomen.
The Appendix arises precisely at the junction between the small intestine and the caecum.
Acute appendicitis is the inflammation of the appendix, and it is the most common cause of acute abdomen in young adults. Thus, appendectomy is the most frequently performed emergency operation in the abdominal region.
Appendicitis usually occurs due to obstruction. The obstruction may occur in:
- The lumen by hard feces or a foreign body
- The appendix wall due to appendix tumors or cancer, but it is a rare condition.
- From the outside by cancer caecum or adhesions from previous intestinal operations.
This obstruction leads to an overgrowth of bacteria, infection occurs, and appendicitis ensues.
Appendicitis is more common in the age group of 20-30 years, but it is rare in older patients. Thus, if appendicitis occurred in old age, doctors must suspect cancer caecum. Appendicitis is also unusual in children below 5 years due to a narrow lumen of the appendix, so obstruction and stasis are not common.
Appendicitis is more common in western countries and urban areas in comparison to rural areas due to low fiber diet, which precipitates constipation and results in hard stool, favoring obstruction, and stasis.
Appendicitis is diagnosed through proper history and examination. The patient complains of severe pain that starts peri-umbilical ( peri = around) and shifts to the right iliac fossa within 6-10 hours, at which the patient can point on the site of pain with one finger. The pain is aggravated by cough or movement and decreases by analgesics.
After a while, the pain may be associated with anorexia, nausea, and vomiting.
On general examination, mild fever may be detected with a slight increase in heart rate.