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Aug 16, 2012

Healthy Living feels the pinch of Appendicitis

The premature death of fourteen year old Marcella Smith on August eighth was devastating for her family. The cause was appendicitis, which can easily be confused with gastroenteritis.  As in Smith’s case, the condition can be fatal if it goes undetected. So this week on Healthy Living, General Surgeon Doctor Philip Burgess explains the early symptoms that parents should look for and why it’s important to seek medical care.

 

Marleni Cuellar, Reporting

The appendix is a small finger-shaped structure that protrudes from your large intestine. It plays no real function in the body, however if it becomes inflamed, it can have severe consequences. The inflammation of the appendix is called appendicitis. It is most common in children but can occur in adults as well. General Surgeon explains some of the common causes for this condition.

 

Phillip Burgess

Dr. Phillip Burgess, General Surgeon

“The most common of which in children; that’s the age group in which appendicitis is most common is just lymph nodes. Lymph nodes are what we call wax & corners that you feel in your neck when you get a cold. Those same lymph nodes are within the wall of the intestine and because the appendix is so narrow, if those lymph nodes get inflamed for whatever reason—a viral infection, maybe a little dehydration that the child is experiencing, or even an adult is experiencing—then those become inflamed and swollen and then they close off what we call the lumen which is the opening of the appendix. That closing off of the opening of the appendix is what leads to the inflammation, bacteria will overgrow and then it affects the blood supply and that is what we call appendicitis.  The other common cause which occurs more often in adults, but does occur in children as well, a little piece of stool can get caught in the lumen of the appendix and that causes inflammation as well.”

 

There is some research that suggests that a high fiber diet may decrease the risk of developing appendicitis. However, a blockage can occur at random to any child or adult; therefore anyone can develop appendicitis. The most common symptom for this condition is abdominal pain.

 

Dr. Phillip Burgess

“That is usually a very vague pain around the navel; sometimes a little bit above the navel—a vague pain that may or may not go unnoticed. But that pain, over the hours, becomes a little more severe and then becomes localized to the right side of the abdomen where the appendix is; right lower abdomen. It becomes more localized over the next few hours of the inflammation and then it starts to become more and more intense and is usually accompanied by anorexia.—you don’t feel like eating; especially in children. Sometimes that is the first sign that the children will show; that they don’t want to eat. After the pain then you start to get nausea and vomiting.”

 

Dr. Burgess noted that very often people mistake appendicitis for gastroenteritis, vomiting & diarrhea. He says the two can be distinguished by the when the nausea sets in. If there is severe pain followed by vomiting then it is more likely an inflamed appendix.

 

Dr. Phillip Burgess

“If the appendix burst, then that pain can actually go away for a while because the pressure has been relieved, but then as all of that inflammatory fluid and bacteria spreads through the abdomen, then the child will get very sick, starts to vomit more, gets very dehydrated and then the pain then starts to spread further throughout the abdomen. From the point of, the onset of pain, usually within forty-eight hours, thirty to thirty-five percent of children will have a ruptured appendix. Adults tend to have a little bit longer time; maybe up to three days or seventy-two hours. Certainly when you pass three days in a child, a large number of them will have a ruptured appendix.”

 

An inflamed appendix is a less critical condition; when it reaches the stage of bursting then it is an emergency. No matter what stage though, both will require surgery.

 

Dr. Phillip Burgess

“You present and once the diagnosis is made, we proceed to surgery. That is the goal standard of treatment for appendicitis. It can be treated both by open surgery, the traditional method where you make a—for both options you are put to sleep—and we make a cut in the lower abdomen which is right above the appendix and remove the appendix in that way. Or, it can be done laproscopically where we use small incisions; maybe three or four, and special instruments and a camera and we remove the appendix in that way. And the advantage of that method is that it is associated with less pain after surgery, patients resume a normal diet faster, they go home faster, more quickly and they also return to their normal activities much more quickly than if they would with an open cut. There is also a decreased risk of infection of the wounds with the laproscopic surgery.”

 

Both types of surgery are available in Belize. Dr. Burgess urges parents to pay close attention to pains that their children may complain about.

 

Dr. Phillip Burgess

“The key is to look out for symptoms and like I said, almost all children or all patients will have abdominal pain. Any abdominal pain which lasts for more than four to six hours—even if it waxes and wanes; even if it goes worse or better—if it lasts for more than six hours and it is not in keeping with a known problem or diagnosis, then you should seek medical attention. If it is in the day, you can see your family practitioner or go to the emergency room and certain in the night, you don’t wait till morning, you don’t leave the child suffering; you take them to the emergency room.”

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Viewers please note: This Internet newscast is a verbatim transcript of our evening television newscast. Where speakers use Kriol, we attempt to faithfully reproduce the quotes using a standard spelling system.

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2 Responses for “Healthy Living feels the pinch of Appendicitis”

  1. Rod says:

    No one should be dying from this in the 21 century but only in Belize.

  2. REEL says:

    Would you beleive a post-mortem done by Estradabran?????

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