Neale ee hd APPENDICITIS PARTA The appendix is a small, thin pouch about 5 to [cm (2 to 4 inches) long. It's connected to the large intestine. Appendicitis is an inflammation of the appendix, a finger-shaped pouch that projects from your colon on the lower right side of your abdomen. Appen uses pain in your lower right abdomen, However, in most people, pain begins around the navel and then moves. Nobody knows exactly what the appendix does, but removing it is not harmful. Coughing or walking may make the pain worse. Common signs of appendicitis are nausea, vomiting and loss of appetite. SIGNS IN CHILD strong pain, mainly around the belly button or in the lower right part of the belly (the pain might come and go at first, then grow steady and intense) © low-grade fever. SIGNS IN MALES Sudden pain that begins on the right side of the lower abdomen, * Sudden pain that begins around your navel and often shifts to your lower right abdomen, © Pain that worsens if you cough, walk or make other jarring movements. SIGNS IN FEMALES + Abdominal pain or tenderness. + Swollen belly. + Constipation. + Diarrhea, + Inability to p: + Low-grade fever (below 100 degrees F). PARTB Appendicitis can be tricky to diagnose unless you have the typical symptoms, which are only present in about half of all cases. Aiso, some people's appendixes may be located in a slightly different part of their body, such as: aed)Nay ee hg + the pelvis + behind the large intestine + around the small bowel + near the right lower part of the liver Some people have pain similar to appendicitis, caused by gastroenteritis constipation, urine infection and IBS. If your symptoms are not typical, further tests may be needed to confirm the diagnosis include: + a blood test (0 look for signs of infection + a pregnaney test for women + urine test to rule out other conditions, such as a bladder infection + an ultrasound scan to see if the appendix is swollen »* aCTscan Your surgeon may recommend a laparoscopy to examine your appendix and pelvic organs if the diagnosis is still uncertain .If they suspect your appendix has burst, you'll be sent to hospital immediately for treatment. PART C If you have appendicitis, your appendix will usually need to be removed as soon as possible. This operation is known as an appendicectomy or appendectomy .In humans, the appendix does not perform any important funetion and removing it does not cause any long-term problems .Removal of the appendix is carried out under general anaesthetic using either keyhole or open surgery. Keyhole surgery: is usually the preferred method of removing the appendix because the recovery tends to be quicker than with open surgery. The operation involves making 3 or 4 small cuts (incisions) in your tummy (abdomen). This is also known as laproscopy. LeenNae ee hd Special instruments are inserted, including: + a tube that gas is pumped through to inflate your abdomen — this allows the surgeon to see your appendix more clearly and gives them more room to work + a laparoscope ~ a small tube with a light and a camera, which relays images of the inside of the abdomen to a television monitor + small surgical tools used to remove the appendix After your appendix has been removed, dissolvable stitches may be used to close the incisions If regular stitches are used, they'll need to be removed 7 to 10 days later. Open surgery: In some circumstances, keyhole surgery is not recommended and open surgery is used instead. + when the appendix has already burst and formed a lump called an appendix mass + when the surgeon is not experienced in laparoscopic removal + people who have previously had open abdominal surgery In open surgery, a single larger cut is made in the lower right-hand side of the abdomen to remove the appendix. When there's widespread infection of the inner lining of the abdomen (peritonitis), it's sometimes necessary to operate through a cut along the middle of the abdomen. This procedure is called a laparotomy. After both types of surgery, the removed appendix is sent to a laboratory to check for signs of cancer. PART D If appendicitis is not treated, the appendix can burst and cause potentially life- threatening infections. If your appendix bursts, the lining of your abdomen (peritoneum) will become infected with bacteria. This is called peritonitis .It can also damage your internal organs. Sometimes an abscess forms around a burst appendix. This is a painful collection of pus that forms when the body tries to fight the infection. In rare cases (about | in 500), an abscess can form as a complication of surgery to remove the appendix, @HQ! PreprationNae NON AN ‘ POST OPERTIVE COMPLICATIONS IN % Open Laparoscopic P appendectomy appendectomy Uncomplicated disease 118 90 Wound infection 10.8) 0 (0) 0.01 Bowel injury 0(0) 1 (1.1) < 0.001 Morbidity (%) 08 1 05 Complicated disease a7 38 Wound infection 6 (12.8) 263) 0.03 Intra-abdominal abscess 11) 26.3) 0.002 Bowel obstruction 5 (10.6) 3 (7.9) 0.37 Respiratory infection 4 (8.5) 263) 0.18 Morbidity 34 23.7 0.12 Total morbidity (%) 10.3 78 0.43 Questions 1-7 For each question, 1-7, decide which text (A, B, C or D) the Information comes from. You may use any letter more than once. In which text can you can find information about. 1. Post-operative complications in laproscopic appendectomy? 2. Which infection mimics the pain of appendicitis? 3. What is called an appendix mass? 4. Is appendix perform any function in the body? 5. What is the complication of appendicectomy? 6. Why keyhole surgery is not recommended in some situations? 7. Benefit of ultrasound sean in appendix? On rnNay ONAN ° Answer the questions,8-14, with a word or short phrase from the texts. Each answer may include words, numbers or both. 8. Which condition can rule out through a urine test? 9. What will make the appendix pain worse? 10. What are the common signs of appendicitis? 1, What is the rate of laproscopic appendectomy in respiratory infection? 12. If appendix is burst, which area in your body will infected? 13. Which is the preferred method of removing appendix? 14, What is the total morbidity rate in open appendectomy? Questions 15-20. Complete cach of the sentences, 15-20, with a word or short phrase from one of the texts, Each answer may include words, numbers or both. 15. Open surgery is recommended for the people who have previously ad. ? 16. After laproscopy).o..:e-cssensnu-esMay be used to close incision? 17. Appendix is connected to TBiss .cis the P value of bow! injury in uncomplicated disease? 19. Some people’s appendixes may be located near the right lower part of... 20. The time duration of removing ordinary stitches are... saeeseees BROCE? Ofc ae aNEETHU'S ONAN . ANSWER KEY 1D a 4. 6. uae oa a 8, BLADDER INFECTION 9, COUGHING 0R WALKING 10. NAUSEA, VOMITING AND LOSS OF APPIETITE, 11, 2(5,3) 12, PERITONEUM 13, KEHOLE SURGERY OR LAPROSCOPY 14.10.3% 15. OPEN ABDOMINAL SURGERY 16. DISSOLVEBLE STICHES 17. LARGE INTESTINE 18, <0.001 19. THE LIVER 20.27 TO 10 DAYS Ped