Appendicitis. Part 6.

At this point diagnosis is usually clear. In cases if it is not, there is Laparoscopy. Laparoscopy is a surgical procedure. Small fiberoptic tube with a camera is inserted into the abdomen through a small puncture in abdominal wall. Yet there is no test that will diagnose appendicitis with 100% certainty. The position of the appendix may vary. If it is longer than normal, appendix may go deep down into the pelvis. It also may move behind the colon (called a retro-caecal appendix). From one hand it is better because retro-caecal appendix has less chances to burst into peritoneal cavity, from the other it is difficult to diagnose and it is difficult to approach surgically. Inflammation of other organs, for example, female pelvic organs, may resemble inflammation of the appendix. Pregnant women may have appendix pushed up in abdomen by the enlarged uterus. Athletic young adults may tolerate more pain and may have not so obvious symptoms of appendicitis. Old patients may have vague symptoms as well. Other inflammatory problems may mimic appendicitis. Surgeons often observe patients with suspected appendicitis for a period of time to see if the problem will resolve or suggest appendicitis more strongly versus another condition. Conditions that mimic appendicitis are: 1) Meckel's diverticulitis. 2) Pelvic inflammatory disease -infection of tube and ovary. It is treated with antibiotics alone 3) Fluids from the right upper abdomen may drip into the lower abdomen and cause inflammation resembling appendicitis. Then, for example, patient has gallbladder disease or liver abscess, but all symptoms suggest acute appendicitis. 4) Diverticulitis that occur on the right side. 5) Inflammation of right kidney. 6) Crohn's disease or ulcerative colitis 7) Yersinia enterocolitica infection - the bacteria that comes form certain food - like unpasteurized milk. - may cause appendicitis 8) passing kidney stone 9) ectopic pregnancy 10) ovarian cyst rupture. And so on. There are some other conditions.


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