Acute appendicitis is one of the most common diseases requiring surgery seen in patients admitted through the Emergency Department. Approximately 7% of people will be affected by this problem and, although it is most common in teenagers, it is seen in people of any age, from little babies through to people in their 90’s.
The appendix is a small worm shaped extension of the first part of the large bowel (the caecum). Acute appendicitis begins when the appendix becomes blocked at its opening to the bowel, the contents of the appendix do not adequately drain and the worm-shaped organ begins to swell. Eventually, the pressure inside the appendix builds up and the ability of the tiny blood vessels to supply the tissue with oxygen from the blood is compromised and the appendix can become gangrenous. If this occurs then the appendix will eventually perforate, or burst, and this will make the sufferer even more sick.
Typical symptoms of appendicitis come on over 6-24 hours, but are sometimes a little faster or slower. Symptoms tend to include generalised abdominal pain which localises to the right lower corner of the abdomen. Other symptoms include a loss of appetite, fevers, loose bowels and feeling generally unwell. Children (and adults) often report that the pain is worst with sudden movement such as going over bumps in the car.
The only proven treatment for appendicitis is surgery, which is typically performed by laparoscopy (keyhole surgery), although a traditional open operation is sometimes better in small children. There is some evidence that, in certain circumstances, appendicitis may be managed with antibiotics alone, however, there are reasonably high early and delayed failure rates and identifying which patients may get better with antibiotics alone remains a challenge. The standard of care in Australia remains surgery however you may discuss your treatment options with your surgeon. Most people go home the day after their operation.