Acute<unk>  is typically managed by surgery. While antibiotics are safe and effective for treating uncomplicated<unk> , 26% of people had a recurrence within a year and required an eventual<unk> pendectomy. Antibiotics are less effective if an<unk> pendicolith is present. Surgery is the standard management<unk> proach for acute<unk> , however, the 2011 Cochrane review comparing<unk> pendectomy with antibiotics treatments has not been updated and has been withdrawn. The cost effectiveness of surgery versus antibiotics is unclear. Using antibiotics to prevent potential postoperative complications in emergency<unk> pendectomy procedures is recommended, and the antibiotics are effective when given to a person before, during, or after surgery. Pain Pain medications (such as morphine) do not<unk> pear to affect the accuracy of the clinical diagnosis of<unk>  and therefore should be given early in the patient's care. Historically there were concerns among some general surgeons that analgesics would affect the clinical exam in children, and some recommended that they not be given until the surgeon was able to examine the person. Surgery Inflamed<unk> pendix removal by open surgery Laparoscopic<unk> pendectomy. The surgical procedure for the removal of the<unk> pendix is called an<unk> pendectomy.<unk> pendectomy can be performed through open or laparoscopic surgery. Laparoscopic<unk> pendectomy has several advantages over open<unk> pendectomy as an intervention for acute<unk> . Open<unk> pendectomy For over a century, laparotomy (open<unk> pendectomy) was the standard treatment for acute<unk> . This procedure consists of the removal of the infected<unk> pendix through a single large incision in the lower right area of the abdomen. The incision in a laparotomy is usually long. During an open<unk> pendectomy, the person with suspected<unk>  is placed under general anesthesia to keep the muscles completely relaxed and to keep the person unconscious. The incision is two to three inches (76 mm) long, and it is made in the right lower abdomen, several inches above the hip bone. Once the incision opens the abdomen cavity, and the<unk> pendix is identified, the surgeon removes the infected tissue and cuts the<unk> pendix from the surrounding tissue. After careful and close inspection of the infected area, and ensuring there are no signs that surrounding tissues are damaged or infected. In case of complicated<unk>  managed by an emergency open<unk> pendectomy, abdominal drainage (a temporary tube from the abdomen to the outside to avoid abscess formation) may be inserted, but this may increase the hospital stay. The surgeon will start closing the incision. This means sewing the muscles and using surgical staples or stitches to close the skin up. To prevent infections, the incision is covered with a sterile bandage or surgical adhesive. Laparoscopic<unk> pendectomy Laparoscopic<unk> pendectomy was introduced in 1983 and has become an increasingly prevalent intervention for acute<unk> . This surgical procedure consists of making three to four incisions in the abdomen, each long. This type of<unk> pendectomy is made by inserting a special surgical tool called a laparoscope into one of the incisions. The laparoscope is connected to a monitor outside the person's body, and it is designed to help the surgeon to inspect the infected area in the abdomen. The other two incisions are made for the specific removal of the<unk> pendix by using surgical instruments. Laparoscopic surgery requires general anesthesia, and it can last up to two hours. Laparoscopic<unk> pendectomy has several advantages over open<unk> pendectomy, including a shorter post-operative recovery, less post-operative pain, and lower superficial surgical site infection rate. However, the occurrence of an intra-abdominal abscess is almost three times more prevalent in laparoscopic<unk> pendectomy than open<unk> pendectomy. Pre-surgery The treatment begins by keeping the person who will be having surgery from eating or drinking for a given period, usually overnight. An intravenous drip is used to hydrate the person who will be having surgery. Antibiotics given intravenously such as cefuroxime and metronidazole may be administered early to help kill bacteria and thus reduce the spread of infection in the abdomen and postoperative complications in the abdomen or wound. Equivocal cases may become more difficult to assess with antibiotic treatment and benefit from serial examinations. If the stomach is empty (no food in the past six hours), general anaesthesia is usually used. Otherwise, spinal anaesthesia may be used. Once the decision to perform an<unk> pendectomy has been made, the preparation procedure takes<unk> proximately one to two hours. Meanwhile, the surgeon will explain the surgery procedure and will present the risks that must be considered when performing an<unk> pendectomy. (With all surgeries there are risks that must be evaluated before performing the procedures.) The risks are different depending on the state of the<unk> pendix. If the<unk> pendix has not ruptured, the complication rate is only about 3% but if the<unk> pendix has ruptured, the complication rate rises to almost 59%. The most usual complications that can occur are pneumonia, hernia of the incision, thrombophlebitis, bleeding and adhesions. Evidence indicates that a delay in obtaining surgery after admission results in no measurable difference in outcomes to the person with<unk> . The surgeon will explain how long the recovery process should take. Abdomen hair is usually removed to avoid complications that may<unk> pear regarding the incision. In most cases, patients going in for surgery experience nausea or vomiting that require medication before surgery. Antibiotics, along with pain medication, may be administered before<unk> pendectomies. After surgery stitches the day after having the<unk> pendix removed by laparoscopic surgery Hospital lengths of stay typically range from a few hours to a few days but can be a few weeks if complications occur. The recovery process may vary depending on the severity of the condition: if the<unk> pendix had ruptured or not before surgery.<unk> pendix surgery recovery is generally a lot faster if the<unk> pendix did not rupture. It is important that people undergoing surgery respect their doctor's advice and limit their physical activity so the tissues can heal faster. Recovery after an<unk> pendectomy may not require diet changes or a lifestyle change. The length of hospital stays for<unk>  varies on the severity of the condition. A study from the United States found that in 2010, the average<unk>  hospital stay was 1.8 days. For stays where the person's<unk> pendix had ruptured, the average length of stay was 5.2 days. After surgery, the patient will be transferred to a postanesthesia care unit, so his or her vital signs can be closely monitored to detect anesthesia- or surgery-related complications. Pain medication may be administered if necessary. After patients are completely awake, they are moved to a hospital room to recover. Most individuals will be offered clear liquids the day after the surgery, then progress to a regular diet when the intestines start to function correctly. Patients are recommended to sit upon the edge of the bed and walk short distances several times a day. Moving is mandatory, and pain medication may be given if necessary. Full recovery from<unk> pendectomies takes about four to six weeks but can be prolonged to up to eight weeks if the<unk> pendix had ruptured.
Appendicitis
Cholecystitis
Cervicitis
Psoas muscle abscess
Gastroenterocolitis
Abdominal aortic aneurysm
Proctocolitis
Adenitis