The presentation of acute appendicitis can vary, but the classic symptoms include :-

→ Abdominal Pain: Acute appendicitis typically presents as vague abdominal pain that starts around the umbilical region and

later localizes to the right lower part of the abdomen. The pain is quite sharp and constant.

→ Nausea and Vomiting: Nausea and vomiting may occur after the onset of abdominal pain.

→ Anorexia: Loss of appetite is a common early symptom.

→ Fever: A low-grade fever may be present, but a high fever can indicate a more severe infection or complications like perforation.

→ Rebound Tenderness: Severe pain when the pressure in the right lower abdomen is suddenly released is a classical and diagnostic sign of acute appendicitis.

→ Perforation:A ruptured appendix can lead to peritonitis, a life-threatening infection of the abdominal cavity.

→ Abscess Formation: Localized collections of pus may form around the appendix, requiring drainage.

→ Sepsis: A severe, body-wide response to infection that can be fatal if not treated aggressively.

The diagnosis of acute appendicitis is primarily clinical but often supplemented by imaging and laboratory tests to confirm and assess the severity. Some of the common tests performed for the diagnosis include :-

Laboratory Tests

→ Complete Blood Count (CBC): Elevated white blood cell (WBC) count with a left shift (increased immature WBCs) suggests infection and inflammation.

→ C-reactive Protein (CRP): Elevated levels indicate inflammation.

Imaging Studies

→ Ultrasound: Often the first imaging modality used, especially in children and pregnant women. It can show a swollen appendix and free fluid.

→ Computed Tomography (CT) Scan:The gold standard for diagnosing appendicitis in adults. It provides detailed images showing an

enlarged appendix, fat stranding, and potential complications like abscess or perforation.

→ Magnetic Resonance Imaging (MRI): Used when radiation exposure needs to be minimized, such as in pregnant patients.

The primary treatment for acute appendicitis is surgical removal of the appendix (appendectomy). The approach to management may vary based on the severity and stage of appendicitis. The treatment protocol depends upon several factors :-

→ Duration of symptoms: The best time to operate this condition is within three days or 72 hours after the onset of symptoms.

→ Formation of appendicular lump: If the patient delays the treatment and radiological investigations show the formation of an appendicular lump, it’s better to plan

conservative management, and surgery is advised after 4-6 of treatment.

→ Development of complications: If the patient has started developing complications like the formation of abscess or pus, high-grade fever, or rupture of the appendix,

urgent surgical intervention is required as it can be life-threatening.

→ Condition of the patient: if the patient delays the treatment and the symptoms settle down, it’s better to postpone the surgery for 4-6 weeks.

This is known as Interval Appendicectomy.

NON-SURGICAL OR CONSERVATIVE MANAGEMENT

Under this plan, the surgeon administers antibiotics to combat infection. Patients are closely monitored for any changes in their condition.

If the symptoms improve, the surgery can be avoided for some time. However, the risk of recurrence remains higher compared to surgical management.

This treatment is mainly recommended in patients having mild symptoms or an uncomplicated appendicitis.

Patients having significant surgical risks in the form of medical diseases like uncontrolled diabetes, high blood pressure, or heart problems can also be advised for conservative management.

Patients presenting late in the hospital after 3-4 days of onset of symptoms and had formation of appendicular lump may be advised to defer surgery for a particular period.

SURGICAL MANAGEMENT - Best Appendicitis Surgeon in Delhi

Surgical management of appendicitis typically involves the removal of the inflamed appendix, a procedure known as an appendectomy,

which can be performed using either Open or Laparoscopic techniques.

The decision to perform open or laparoscopic appendicectomy depends upon the experience and expertise of the surgeon as well as the condition of the patient.

Patients having significant surgical risks in the form of medical diseases like uncontrolled diabetes, high blood pressure, or heart problems can also be advised for conservative management.

Open Appendicectomy

The procedure requires a larger incision in the lower right abdomen. The surgery is associated with increased morbidity,

delayed recovery, and increased risk of complications.

The surgery is usually reserved for patients unfit for general anesthesia and patients having a severe abdominal infection or sepsis.

Appendicitis Laparoscopic Surgery

Laparoscopic Appendicectomy, a minimally invasive surgical procedure for removing the appendix, has become the gold standard for the removal of the appendix.

The laparoscopic surgeon can access the abdominal cavity with remarkable precision by utilizing small incisions and guided by a high-definition camera known as a laparoscope.

This approach reduces postoperative pain and significantly shortens recovery times compared to traditional open surgery.

An experienced and expert surgeon can easily navigate complex anatomy while minimizing tissue trauma, which contributes to lower rates of complications and faster return to normal activities for patients.

T The success of the surgery entirely depends upon the experience and expertise of the surgeon.

T A highly skilled surgeon can easily handle even complicated cases using minimally invasive techniques.