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Does Appendicitis Require Surgery?

By:
Ronen Arai

Question :

Is it possible to treat a mild case of appendicitis without surgery -- say, using just antibiotics and rest?

Jaco

Answer :

The appendix is a small pouch located at the beginning of the colon in the lower right side of the abdomen. Appendicitis is a condition that is caused most commonly by obstruction of the appendix, resulting in inflammation and infection that can lead to perforation and an abscess in the abdominal cavity. The obstruction usually begins when a small piece of stool becomes stuck in the opening of the appendix and does not dislodge. The obstruction can also occur as a result of a tumor or parasite, but these are much less common causes.

While obstructed, the lining of the appendix continues its normal production of fluids. These build up, leading to high pressures, which can cause inflammation, ulceration and infection. Appendicitis can also be caused by nonobstructing causes such as bacterial and viral infections.

The diagnosis of appendicitis is sometimes difficult because there are many potential causes of lower right-sided abdominal pain. In the past, it was common to operate based on a likelihood that appendicitis was present. However, with newer ultrasound and CT scanning techniques, the diagnosis can often be made before surgery.


To answer your question, the treatment for appendicitis is surgery, even for mild cases. The operation involves making a small incision in the lower right side of the abdomen and removing the appendix. In more complicated cases -- for example, if the appendix has ruptured, or if the infection has spread to the adjacent colon -- a larger incision may be needed. In some cases, part of the colon may need to be removed. Antibiotics are always given in any case of appendicitis, but are used to help prevent spread of the infection, not as primary therapy instead of surgery.

 

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