Appendicitis

Appendicitis

It is an acute inflammation of the vermiform appendix, a narrow, blind tube that extends from the inferior part of the cecum. The appendix has no known function but does fill and empty as food moves through the gastrointestinal tract. Appendicitis begins when the appendix becomes obstructed or inflamed. Following obstruction of the lumen, a continued secretion of mucus produces distension of the distal end. The distension results in ischemia of the wall with bacterial proliferation. Subsequently, a patchy necrosis, gangrene and perforation develop resulting in peritonitis and sepsis and finally death.

An appendectomy (surgical removal of the appendix) is the preferred method of management for acute appendicitis if the inflammation is localized. An open appendectomy is completed with a transverse right lower quadrant incision. If the appendix has ruptured and there is evidence of peritonitis or an abscess, conservative treatment consisting of antibiotics and intravenous (IV) fluids is given 6 to 8 hours prior to an appendectomy. Generally, an appendectomy is performed within 24 to 48 hours after the onset of symptoms under general anesthesia. Preoperative management includes IV hydration, antipyretics, and antibiotics administration.

Anesthetic Management of Appendicitis: Consider anesthetic management for emergency patient.