Appendicitis - Medical Malpractice Lawyers

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Appendicitis - Medical Malpractice

Appendicitis happens when the appendix becomes infected and inflamed. The appendix extends from the most proximal portion of the large intestine, near where it attaches to the small intestine. It has no specific function that we know of. When it is removed, there are no specific consequences so it is assumed that it has a vestigial function that is not required today.

Appendicitis is a medical emergency that needs emergency surgery to remove the appendix. If not removed, the appendix can burst and cause peritonitis, which can be life threatening. An abscess can form around the appendix if it bursts which can lead to chronic pain and debility. Scar tissue walls off the infection when the abscess forms and it needs surgery to remove the abscess and the infected appendix in order to clear up the problem. Antibiotics alone won't take care of an abscess. In the same way, antibiotics alone won't treat a case of appendicitis and it takes surgery plus antibiotics to take care of the problem.

One in about 15 people will get appendicitis. It is rare before the age of two and is most common between those individuals aged 10 to 30. The most common way appendicitis occurs is when stool, a fecolith, a foreign body or cancer blocks the appendix and causes it to become infected and inflamed behind the blockage.

The main symptoms of appendicitis include a pain that begins around the navel and then gradually travels to the right lower quadrant. There is rebound tenderness when pushing on the abdomen in the right lower quadrant. Loss of appetite is common as is nausea and vomiting. The abdomen can swell and there is generally a fever between 99 degrees and 102 degrees. There is an inability to properly pass gas.

Other symptoms that are less common include pain in the rectum, back or upper abdomen, pain on urination, vomiting without abdominal pain, severe crampy abdominal pain and constipation or diarrhea. Gas builds up in the colon and is painful.

Appendicitis is best diagnosed with a careful history and physical examination. The examination includes palpating the right lower quadrant of the abdomen and noting rebound tenderness at McBurney's point. This is a specific area halfway between the umbilicus and the right iliac crest. The temperature must be taken and a CBC can be drawn to see if there is an elevation in the white blood cell count. A urine test can rule out a urinary tract infection and a rectal exam can show rectal pain on the right side. CT scan or ultrasound of the abdomen can show abscesses and inflammation of the appendix.

The treatment of appendicitis is mainly surgical. The procedure, called an appendectomy, is used to remove the infected and inflamed appendix, and any abscesses that might have developed. Antibiotics are given around the time of surgery and sometimes given for a few days after the surgery. Doctors tend to err on the side of taking out suspected appendicitis so as to avoid complications, even if a few normal appendices are removed in the process. Sometimes two surgeries are required: one to remove the abscess and debris and the second to remove the appendix itself. Antibiotics are given before surgery to reduce the chances of getting peritonitis.

The recovery from appendicitis is usually fairly easy. You are usually up and around within twelve hours post surgery. Normal activities can be resumed within 2-3 weeks. Surgery can be done with a laparoscope so that the recovery time is shorter and there are fewer complications. You should call the doctor if you have persistent vomiting after surgery or if you have increased pain, dizziness, blood in the urine or incisional redness. Fever and pus in the wound are not normal and should be looked at by the doctor.

The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here