The appendix is a worm-like structure attached to the junction of the small intestine and large intestine.  Appendix vermiformis is a small, narrow tube found at the end of the caecum, which is a pouch-like structure at the intersection between the small and large intestine. The exact biological function of the appendix is unknown.Medical students are taught it as a vestigial structure. This means a part that has no specific function to do.

Appendix serves a purpose in animals. It is present in the process of animals were supposed to digest food storing it in the appendicular pouch. It seems absurd as nothing much gets digested in the large bowel. For whatever reason it is there; it has become a frequent troubleshooter and a major cause of pain abdomen. Patients usually present with pain in the abdomen.

In acute appendicitis, there is a sudden onset of pain. In some cases, it is very severe and needs hospitalization and treatment. Previously it was an emergency case and there was a need to operate it as an emergency case. With advances in health care, they get admitted and surgery will be on the next available operation day.

There are cases wherein patients have repeated attacks of the pain getting well on its own. “Our body has a great inbuilt hospital system designed to heal any kind of illnesses.” Even these cases might require surgery at some stage.

In some cases, appendix gets burst very fast and needs emergency treatment Often appendectomy might be a very simple and straightforward surgery. But on some occasions, the best of the surgeons struggle to do the surgery. On the table, it could be popping up when we open the abdomen, called peeping appendix. In worst cases, we will have to be satisfied doing adhesions release and close the abdomen.

Appendicitis Differential Diagnoses

Different disorders within the abdominal region may cause pain in different regions. For example, gastritis is usually felt in the left upper abdominal quadrant, while pain from an inflamed gallbladder or gallstones is felt in the right upper region. Pain which is experienced in the region of the appendix may be from acute appendicitis, but it may also result from other disorders and diseases of organs in the abdominal region. Good to know that pain from kidney problems is usually described as being in the back or side, rather than a pain in the abdomen.(1) Often appendicitis is confused with ureteric colic in females.

Other Differential Diagnoses

Acute mesenteric adenitis

Intussusception

Viral gastroenteritis

Right-sided ureteric stone

Meckel’s diverticulitis

Crohn’s disease

Peptic ulcer disease

Cholecystitis

Urinary tract infection

Primary peritonitis

Pelvic inflammatory disease

Ruptured Graafian follicle (mittelschmerz)

Ectopic pregnancy

Ovarian torsion

Appendicitis treatment

With the availability of ultrasound and other imaging modalities, the diagnosis can be near perfect. Plenty of appendectomies were done before the imaging era mistakenly. Blood tests, sonography etc. only helps the doctor to diagnose. “There is nothing better than an experienced hand that can do the accurate diagnosis.”

Appendectomy is done laparoscopically also. If cost is not an issue it’s. Again the expertise and the facilities at the institute are important. Finally, a lot of appendectomies are done unfortunately either to reach the targets or to claim Insurance benefits. The corporate system runs on balance sheets “Humanity gets forgotten and many abdomens opened for no fault.”

Let us all aspire to be HUMAN.

“Love is like the human appendix. You take it for granted while it’s there, but when it’s suddenly gone you’re forced to endure horrible pain that can only be alleviated through drugs.”

“Idleness is an appendix to nobility”. – Robert Burton

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Image credit : Royalty free images

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  1. Practical approach to the problem

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