A Short Note On The Appendix And The Abscess

When first attempting anything, there is always going to be some sort of pressure to perform well. Dr. William Nolen, in his short story, “The First Appendectomy”, clearly expresses the stress he endures while performing his first surgery to the reader by his descriptions of the surgery. When he begins the surgery, he shows his first sign of stress, saying “I was ready to begin. Suddenly my entire attitude changed. A split second earlier I had been supremely confident; now, with the knife finally in my hand, I stared down at Mr. Polansky’s abdomen and for the life of me could not decide where to make the incision” (Nolen 147). Though Nolen was confident he could handle the surgery with ease, he ends up uncertain of what he is doing. He is straining

Appendectomy is the surgical removal of the appendix, which is a long narrow tube that attaches to the first part of the colon. It’s located in the lower right side of the abdomen. The appendix is a vestigial organ, and it has no known relevant function.

Abdomen: The lipases appeared unremarkable. The liver, spleen, gallbladder adrenals, kidneys, pancreas and abdominal aorta appeared unremarkable. The bowels seen on the study appeared thickened. Dilated appendix seemed consistent with acute appendicitis. All the structures of the abdomen appeared unremarkable. No free air was seen.

b) Place hand above right knee and ask pt to raise the leg to meet your hand. Pain may indicate appendicitis.

Patients present with left lower quadrant pain, reiterating the tendency for diverticulitis to affect the sigmoid colon in western countries. The pain can be constant or intermittent, and lack of appetite, or nausea and vomiting can be present. Physical examination of the abdomen reveals localized tenderness but frank rebound or guarding should be negative. Bowel sounds are frequently distant or depressed, if bowel sounds are very active an obstruction may be present, in mild cases the bowel sounds may be normal. The WBC may be elevated and the patient may present with a fever. Occasionally a palpable mass may be felt and may be very painful. Eating exacerbated the pain of left-sided diverticulitis and pain can be lessened with the passage of feces or flatus. Patients may complain of a feeling of being bloated.

Every year a familiar scene plays out in clinic waiting rooms, chairs filled with miserable patients waiting to see their physician with complaints of a never ending cough and a constant nasal drip. More than likely, these patients will receive a prescription for antibiotics, but should they? Most acute respiratory tract infections (ARTIs), do not require an antibiotic, the symptoms will resolve themselves over time without antibiotic treatment. Healthcare experts and scientists have warned the public about the dangers of overusing antibiotics, and there are thousands of studies to support that fact, but no one is listening. Patients are convinced they need to have antibiotic treatment, and somehow their time is wasted if they leave empty

Children ages 10-19 years are most commonly diagnosed with appendicitis. Appendicitis is often more difficult to diagnose in children than adults, because of this about 10-20 percent of kids with appendicitis will suffer from a perforated appendix before being treated. When the appendix is blocked, it becomes inflamed and bacteria can overgrow in it. Blockage can be due to stool, inflammation of lymph nodes in the intestines, or infections like parasites. A perforated appendix is one of the complications of acute appendicitis. If appendicitis is left untreated, ischemic necrosis of a portion of appendixes wall may occur, leading to perforation. This then allows the contents in the appendix to leak out into the rest of the abdomen, potentially causing other infections, such as septicemia. This can be a life threatening

Upper respiratory tract infections (URTI), including acute otitis media (AOM) are the most common cause of ambulatory physician visits and antimicrobial prescriptions in children1,2. The most common bacterial causes of URTI are Streptococcus pneumoniae and Haemophilus influenzae, though the majority of cases are caused by viral pathogens 3–10. Distinguishing between viral and bacterial URTI can be difficult. Reports on quality of antimicrobial prescriptions have shown a 30-50% of all out-patient prescriptions due to (upper) respiratory tract infections to be inappropriate2,10,11. In Europe the quality of prescription is higher in the north of the continent, including Iceland compared to in the south12. Conversely, many factors contribute to the overuse of antimicrobials2,13–15, which in turn results to increase in antimicrobial resistance16,17. Contributing factors cited by by physicians to cause over-prescription include uncertainty of diagnosis, fear of disease complications, lack of perception of harmful effects of antimicrobials, not perceiving their own prescription practices to be a problem, pressure by patients, limited time, fear of damaging doctor-patient relationship in addition to language, cultural and educational barriers2,13–15. Antimicrobials were long a mainstay treatment against AOM in fear of rare, but dangerous complications, which have later been found to be unfounded, asnd

This operation requires 3 to 5 small incisions be made in your lower stomach. A medical laparoscope is an instrument with a slender tube and an attached camera that the surgeon puts into one of the incisions in order to see where the damaged area is located. Your stomach is filled with gas so that the surgeon has a good view of the area where he will be working. One larger cut may be required if the surgeon needs to put a hand inside of the stomach to help remove the colon. It is not unusual to remove some lymph nodes while removing the damaged areas. The incisions will be closed with stitches or staples.

In this study, out of 112 patients operated for acute non perforated appendicitis, 72 patients were male and 40 patients were female, a ratio of 1.8:1. The patients' age ranged from 18 to 55 years with a mean age of 26 years, the majority of cases lie in a range between 20-32 years. As shown in Table 1, there is no significant difference regarding patients' age, sex, medical comorbidities (diabetes, liver disease, renal disease, hyperlipidemia, heart disease), fever, leukocytosis, radiologic findings (appendiceal diameter, presence of free fluid) or operative time between the two groups.

Postsurgical infection treatment cost negatively impact hospital’s finance and creates a financial burden on the hospital. The financial burden of surgery is increased due to the direct costs incurred by the prolonged hospitalization of the patient, diagnostic tests, and treatment. “Infections related to coronary artery bypass graft (CABG) surgery are some of the most serious infections that require additional costs $40,000 to $50,000” (CABG Infections …, CMS Pay 2008). According to, Contemporary…, this serious and costly errors in the care delivery should never happen. Furthermore, “Hospitals can be penalized up to 1% initially of an organization’s baseline annual Medicare reimbursement” (Cherry, Jacob, 2017, p.392) for performing poor patient

A 42-year-old man with severe right-sided abdominal pain, nausea, vomiting, and fever presented to the emergency room. After obtaining a computed tomography scan with contrast, he was taken to the operating room for an emergent laparoscopic appendectomy. His medical history was significant for long-standing hypertension but recent onset weight loss, dysphagia, heat intolerance, palpitations, diarrhea, and dyspnea. He had received general anesthesia multiple times without complications.

Diverticulitis is inflammation of one or more diverticula located within the intestine. This condition results when the diverticula (small out pouches in the colon) become swollen and perforate through the mucosal and serosal layers of the intestine (Nettina, 2014). This inflammation leads to bacterial overgrowth and ischemia which further complicates the condition Signs and symptoms for diverticulitis include: left lower quadrant pain, low-grade fever, urinary frequency, dysuria, peritonitis with abdominal rigidity, and abdominal distention (Ignatavicius, 2013). Management for the condition depends on the severity. If the symptoms are mild to moderate, treatment can be done in an outpatient setting with use of broad-spectrum antibiotics. When deep perforation has occurred, as with this patient, surgical management is required to resection the diseased area of the colon (Nettina, 2014). Depending upon the type of colon resection, a colostomy is also considered.

A 54-year-old man presents acutely with anterior NSTEMI and is treated with PCI (Drug eluting stent) to the LAD and placed on DAPT (aspirin 300mg and ticagrelor 75 mg bd). He subsequently develops abdominal pain, which is confirmed as acute appendicitis on CT scan and is referred by the surgical unit for laparoscopic appendicectomy.

In the article, “Appendix Evolved More Than 30 Times,” Colin Barras states that the appendix is a “wormlike structure found near the junction of the small and large intestines evolved 32 times among mammals.” Barras is describing the evolution of the appendix and the whether or not human beings need this