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Infections and Inflammations

An infection is the condition of multiplication of parasitic organisms or microorganisms
within the body. An inflammation is the reactions that occur in the affected blood
vessels and adjacent tissues in response to an injury or abnormal stimulation
caused by a physical, chemical, or biologic agent. Many people use the terms
interchangeably since they have several symptoms in common and usually
are treated similarly.

Appendicitis :: Pancreatitis :: Hepatitis :: Cholecystitis
Oesophagitis :: Peritonitis

Appendicitis

Appendicitis is an inflammation of the appendix, a small worm-like pouch attached
to the large bowel. It can happen at any age but most cases are between 8 and 25
years of age. For young people, appendicitis is probably the most common cause
of stomach pain requiring emergency surgery.

Causes

In most cases, the specific reason for the inflammation is not known but it is due
to blocking of the opening connecting the large intestine and appendix. In many
cases it is caused by small pieces of hardened stool (faecaliths) that get stuck
in the appendix.

Symptoms

The first sign is usually a pain or discomfort in the centre of the abdomen. The
pain usually begins near the umbilicus and moves down and to the right. This
pain comes and goes in waves and increases on movement. Pain is often
thought at first to be a simple stomach upset.

• nausea
• vomiting
• constipation
• diarrhoea
• inability to pass gas
• low fever that begins after other symptoms
• abdominal swelling
• anorexia

Diagnoses

• The doctor takes a medical history from the patient and checks
  their temperature.
• Blood and urine tests are performed to look for infection.
• The doctor examines the patient by pressing on the lower right
  part of the abdomen and sometimes by inserting a finger in the
  anus (back passage) in order to exclude other causes of pain.
• Women are often given a vaginal examination.

There is no one test that will diagnose appendicitis with certainty, usually
doctors use CT scan or ultrasound to see whether the appendix looks inflamed.
Surgery is performed on the basis of the doctor's examination and results of
the tests. Many diseases can cause the same symptoms as appendicitis.

Course of illness

The inflammation can cause infection, a blood clot, or rupture of the appendix.
Because of the risk of rupture, appendicitis is considered an emergency. Anyone
with symptoms needs to see a doctor immediately.

Treatment

• Surgical removal of the appendix (appendicectomy) is the most common
  procedure. A 3-6cm horizontal incision is made in the lower part of the
  abdomen on the right side, through which the appendix is removed.
• In some hospitals, the appendix is routinely removed by a keyhole
  operation or the insertion of a three-fibre optic camera through the
  stomach (laparoscopy).

In uncomplicated cases, a two to three day hospital stay is typical. The person
can go home when their temperature is normal and their bowel starts to function
again. The stitches are removed 10 days after the operation. A return to ordinary
daily life within four to six weeks is usual.