Appendicitis belongs to which department?

Written by Zhang Peng
General Surgery
Updated on November 08, 2024
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Appendicitis falls under the domain of general surgery, and its pathological changes can be categorized into several types. The first type is acute simple appendicitis, characterized by mucosal congestion and edema, with patients typically presenting mild symptoms. The second type is acute suppurative appendicitis, also known as cellulitis, where symptoms worsen, and patients may develop fever and experience tenderness and rebound pain in the lower right abdomen. The third type includes acute gangrenous and perforative appendicitis, where the condition further worsens. The appendix wall is necrotic or partially necrotic, and perforation usually occurs at the proximal end of the appendix, potentially leading to the formation of a periappendiceal abscess. If the perforation extends into the abdominal cavity, it can lead to diffuse peritonitis, often requiring emergency surgical exploration. The fourth type involves a periappendiceal abscess, typically progressing slowly. The omentum can move to the lower right side and envelop the appendix, forming adhesions and leading to the formation of an abscess. Most cases are treated conservatively, and traditional Chinese medicine is used adjunctively to promote the absorption of the abscess.

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Written by Ren Zheng Xin
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Does appendicitis surgery require an incision?

Appendicitis surgery can be performed through traditional open surgery or minimally invasive treatment. Open surgery involves a traditional incision at McBurney's point to remove the appendix, which is now rarely used, predominantly replaced by minimally invasive treatment under laparoscopy. The procedure is the same for both methods, involving ligation of the appendicular artery followed by cutting the appendix at its base and suturing the stump. The advantages of minimally invasive surgery include less intraoperative bleeding, faster postoperative recovery, and less physical trauma. Patients can choose between open surgery or minimally invasive treatment based on their personal circumstances and financial conditions.

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Written by Ren Zheng Xin
Gastroenterology
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How long to rest after appendicitis surgery?

After an appendectomy, if there is no significant suppuration or infection, a recovery period of at least two weeks is required. During this period, it is important to rest, pay attention to diet, increase nutrition, and increase protein intake, such as eating more chicken, fish, and soy products. Also, consume more vegetables and fruits, engage in appropriate exercises to increase gastrointestinal motility. The surgical incision should be dressed regularly, and sutures can be removed after a week post-operation, then depending on the condition, decide whether to change the dressing again.

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Written by Li Jin Quan
General Surgery
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Where does chronic appendicitis hurt?

Chronic appendicitis, unlike acute appendicitis, does not begin with upper abdominal pain followed by pain in the lower right abdomen, which we refer to as migratory lower right abdominal pain; migratory lower right abdominal pain is a characteristic symptom of acute appendicitis. Chronic appendicitis typically presents with chronic recurrent pain, discomfort, dull pain, or bloating in the lower right abdomen. During a physical examination, chronic appendicitis generally manifests as fixed tenderness in the lower right abdomen, with less evident rebound pain. Rebound pain in the lower right abdomen during a physical exam only occurs when chronic appendicitis acutely flares up and signs of peritonitis are present.

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Written by Ren Zheng Xin
Gastroenterology
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Is appendicitis prone to recurrence?

For acute appendicitis, if the appendix is not removed surgically, it is relatively prone to recurrence, and chronic appendicitis may also develop. Therefore, once appendicitis is diagnosed, surgery to remove the appendix is generally required. The more commonly used surgical method is laparoscopic appendectomy. This method involves less bleeding during the surgery and quicker postoperative recovery, with minimal damage to the body. Only small scars can be seen on the body surface, making it a preferable option for those concerned about aesthetics.

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Written by Zhang Peng
General Surgery
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Characteristics of Appendicitis Pain

The most typical pain manifestation of appendicitis is migratory pain, which generally starts in the upper abdomen or around the navel, and in most cases moves to the lower right abdomen and becomes fixed within a few hours. During physical examination, the pain usually localizes to a fixed point in the lower right abdomen, typically at McBurney's point, although this can vary with the position of the appendix. However, as the condition of the appendix progresses, such as when it becomes purulent or even gangrenous, the inflammation worsens and the area of tenderness can expand. This is mostly manifested by symptoms of peritoneal irritation, which are generally indicative of the timing for surgery. In most cases of appendicitis where the diagnosis is clear, early surgical intervention is recommended, as surgery is the only cure. Most patients who improve with conservative treatment are likely to experience recurrence later on.