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Appendix

Appendicitis / Appendix - Appendicitis1The appendix sits at the junction of the small intestine and large intestine. It’s a thin tube about four inches long. Normally, the appendix sits in the lower right abdomen.

Appendicitis

Appendix
appendicitis1The appendix sits at the junction of the small intestine and large intestine. It’s a thin tube about four inches long. Normally, the appendix sits in the lower right abdomen.

Appendicitis
Appendicitis is a condition in which your appendix becomes inflamed and fills with pus. Your appendix is a finger-shaped pouch that projects out from your colon on the lower right side of your abdomen. This small structure has no known essential purpose, but that doesn’t mean it can’t cause problems.

Symptoms:

  1.  Aching pain that begins around your navel and often shifts to your lower right abdomen
  2.  Pain that becomes sharper over several hours
  3.  Tenderness that occurs when you apply pressure to your lower right abdomen
  4.  Sharp pain in your lower right abdomen that occurs when the area is pressed on and then the pressure is quickly released (rebound tenderness)
  5.  Pain that worsens if you cough, walk or make other jarring movements
  6.  Nausea
  7.  Vomiting
  8.  Loss of appetite
  9.  Low-grade fever
  10.  Constipation
  11.  Inability to pass gas
  12.  Diarrhea
  13.  Abdominal swelling

 

 

Causes:

An obstruction:
Food waste or a hard piece of stool (fecal stone) can block the opening of the cavity that runs the length of your appendix.

An infection:
Appendicitis may also follow an infection, such as a gastrointestinal viral infection, or it may result from other types of inflammation.

Complications:
A ruptured appendix:
If your appendix ruptures, the contents of your intestines and infectious organisms can leak into your abdominal cavity. This can cause an infection of your abdominal cavity (peritonitis).

A pocket of pus that forms in the abdomen:
If your appendix has burst, infection and the seepage of intestinal contents may form an abscess — a pocket of infection (appendiceal abscess) around the appendix. Appendiceal abscess requires treatment before the abscess tears, causing a more widespread infection of the abdominal cavity.

Treatments:
Laparotomy (Open Surgery): Laparotomy is the traditional type of surgery used for treating appendicitis. This procedure consists in the removal of the infected appendix through a single larger incision in the lower right area of the abdomen. The incision in a laparotomy is usually 2-3 inches long. This type of surgery is used also for visualizing and examining structures inside the abdominal cavity and it is called exploratory laparotomy.

Laparoscopic Surgery: The laparoscopic (minimally invasive) surgical technique involves making several tiny cuts in the abdomen and inserting a miniature camera and surgical instruments. As many as three or four incisions are made. The surgeon then removes the appendix with the instruments, so there is usually no need to make a large incision in the abdomen. The camera projects a magnified image of the area onto a television monitor which helps guide the surgeons as they remove the appendix. Laparoscopic surgery also requires general anesthesia and it can last up to two hours.

Cholecystectomy

Gallbladder
This organ lies near the liver. It stores bile that is made by the liver. Bile helps in the digestion of fatty foods. The gallbladder releases bile into a system of ducts that lead to the small intestine.


Cholecystectomy
A cholecystectomy is an operation to remove the gallbladder. It is performed when the gallbladder requires removal due to inflammation (cholecystitis), stones (cholelithiasis), or both.

Causes:

  1.  Gallstones in the gallbladder (cholelithiasis)
  2.  Gallstones in the bile duct (choledocholithiasis)
  3.  Gallbladder inflammation (cholecystitis)
  4.  Pancreas inflammation (pancreatitis)

Risk:

  1.  Bleeding
  2.  Infection
  3.  Injury to other nearby structures or organs
  4.  Reactions to general anesthesia
  5.  Blood clots
  6.  Age: 60 or older
  7.  Pregnancy
  8.  Obesity
  9.  Smoking
  10.  Malnutrition
  11.  Recent or chronic illness
  12.  Diabetes
  13.  Heart or lung problems
  14.  Bleeding disorders
  15.  Alcoholism and use of street drugs
  16.  Use of certain medicines

 

Surgery:
(Open) Cholecystectomy: During open cholecystectomy your surgeon makes a 6-inch (15-centimeter) incision in your abdomen below your ribs on your right side. The muscle and tissue are pulled back to reveal your liver and gallbladder. Your surgeon then removes the gallbladder. The incision is sutured, and you’re taken to a recovery area. Open cholecystectomy takes one or two hours.

(Laparoscopic) Cholecystectomy: During laparoscopic cholecystectomy, the surgeon makes four small incisions in your abdomen. A tube with a tiny video camera is inserted into your abdomen through one of the incisions. Your surgeon watches a video monitor in the operating room as special surgical tools are inserted through the other incisions in your abdomen and your gallbladder is removed.

Gastrectomy

A gastrectomy is a partial or full surgical removal of the stomach. Gastrectomies are performed to treat cancer and perforations of the stomach wall.

Types of Gastrectomy

  1.  Total gastrectomy, where the whole stomach is removed.
  2.  Partial gastrectomy, where the lower part of the stomach is removed.
  3.  Sleeve gastrectomy, where the left side of the stomach is removed.
  4.  Oesophagogastrectomy, where the top part of the stomach and part of the oesophagus (gullet) is removed.

Risk:

  1.  Severe medication reaction
  2.  Problems in breathing
  3.  Bleeding
  4.  Infection
  5.  Obesity
  6.  Advanced age
  7.  Smoking
  8.  Poor nutritional status
  9.  Respiratory disease or cardiac disease

Treatments:
Open Gastrectomy:

During an open gastrectomy, the surgeon makes a large incision in your abdomen to remove some or all of your stomach.

Keyhole Surgery (Laparoscopic Gastrectomy):
The surgeon makes several smaller cuts in your abdomen, and then uses a special telescope and small surgical instruments to remove some or all of your stomach