Non Perforated Appendicitis Case Study

When you’re young, the most common injuries are: a broken arm, a sprained ankle, or a skinned knee and elbow. Not a ruptured appendix. In fact, the chance of developing appendicitis is about seven to fourteen percent. Although it is most prevalent in children and young adults, and one of the most common operations today, it was unfamiliar to my parents.

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.

The aged old open appendectomy has been the main form of corrective surgery for patients who was diagnose with acute appendicitis. However, in the modern era, the laparoscopic approach has become more common and many have questioned its effectiveness and superiority over the appendectomy (Biondi, et al 2016). The laparoscopic approach has been identified for shorter recovery time post operatory, thus resulting in shorter hospital stay, less postoperative pain, faster return to daily activities. These observations influenced, Biondi, et al (2016), to conduct a retrospective observational study at the department of Emergency Surgery, Garibaldi Hospital-Catania during the period of January 2004 and July 2011 with the purpose of identifying the

Although many steps are necessary to prevent Surgical Site Infections, one important step is the use of perioperative antiseptics, which will be considered in detail below. According to the 2016 Surgical Site Infections guidelines from the World Health Organization, “SSI is the most common healthcare associated infection among surgical patients with 77% of patient deaths reported to be related to infection”.

When the surgeon came out to update my parents he said, “Well, in the doctor's world, we say, We hit the Jackpot with your daughter.” He went on to explain my appendix was healthy, but I had Meckel's Diverticulitis. My surgeon was thrilled with the diagnosis because according to him this is a condition he has always studied in a book, but never had the opportunity to treat a case for himself. Meckel’s Diverticulitis is an extra piece of tissue attached to the small intestine that once it becomes inflamed must be removed. Unfortunately for me, I was the guinea pig the surgeon’s had the opportunity to study a condition only 2 to 3% of people are born

According to Laurell, Hansson and Gunnarsson (2013), appendicitis is one the most common differential diagnoses among young males and accounts for a vast number of complaints of acute abdominal pain to the right iliac fossa with nausea and a loss of appetite. The inflamed appendix may develop secondary to blockage from either inflammation or stool and the diagnosis criteria consists of collecting assessment data like, an elevated white blood cell count, c-reactive protein and confirmation with either a computed tomography (CT) or ultrasound (Purysko, 2011). Acute appendicitis requires immediate treatment to avoid spread of infection and prevent the risk of the individual becoming septic. Other non-emergent causes of acute abdominal pain may include gastroenteritis and hernia. An acute cause of abdominal pain in the 50-year-old male would consist of biliary disease like acute cholecystitis (Sullivan, 2011). The individual would most commonly present with four clinical symptoms, a Murphy's sign (palpation with inhalation), acute pain in the right upper abdomen, leukocytosis, and possibly febrile (Schuld & Glanemann, 2015). This disease is an emergency requiring immediate surgical intervention known as a cholecystectomy and is often triggered by biliary obstruction of stones or bacterial infection resulting in possible

The purpose of the research study conducted in “A Colorectal ‘Care Bundle’ to Reduce Surgical Site Infections in Colorectal Surgeries: A Single-Center Experience” was to identify whether the surgical bundles implemented were effective in reducing surgical site infections post-surgery. The case study’s objective was to determine an effective intervention, which was evidence-based, to implement into practice to reduce surgical site infections following surgery. According The Joint Commission, The Joint Commission National Patient Safety Goal seven is to reduce the risk of health care-associated infections (The Joint Commission, 2017), which correlates directly with the efforts of both the article and the case study in reducing surgical site infections. The purpose of the research study, the case study, and the Joint Commission National Patient Safety Goals (goal 7) is to reduce the amount of health-care infections (specifically surgical site infections). The patients of the case study had an average-mean age of 45. Age was not specified in the article. The patients of both the article and case study underwent gastrointestinal surgery. The setting of the case study was a medical surgical unit in a Philadelphia hospital, while the setting of the article was

The patient did not go home with any medications due to the fact that her appendix had not ruptured and she had stated that she did not want any prescription pain medication. She was instructed to take a NSAID such as Motrin if she still had pain. She was told to monitor her three incision sites, which should be dry and completely closed. If the edges of the incision started to come apart or if blood or pus were draining from the incisions, she was told to notify the doctor immediately. She said that she understood these

Complications from surgery can cause an increase in patient suffering, increase the number of days confined in the hospital, escalation in health care costs and in serious cases, even cause death. Surgical site infections (SSIs) as a complication in surgery remain a serious concern for healthcare providers, including physicians, nurses, hospital administrators and even insurers who are liable for health care costs incurred in the hospital. SSIs, which increases the risk of patient mortality, often requires prolonged treatment and results in economic burden, have dire implications for the facility, surgeons, and more importantly for the patient (Kapadia, Johnson, Daley, Issa, & Mont, 2013). Kapadia et al. (2013)

We all know that with surgeries there is always a chance of complications that may occur, whether it’d be during, or after. The HAIs, Health Care-Associated Infections one of the most common infections are Post-operative in the healthcare system, these are known as Surgical Site Infections (SSI). According to the Centers for Disease Control and Prevention (CDC) about 1 to 3 out of almost every patient that has surgery an infection does develop (FAQS about Surgical Site Infections)

Y.M. was admitted to Selma hospital after receiving diagnosis of having acute appendicitis, so she underwent a laparoscopic appendectomy. In summary, appendicitis is defined as, inflammation of the vermiform appendix as a result of an obstruction in the lumen of the appendix (Huether & McCance, 2012). Like all surgeries, even the smallest ones, complications can occur at any time during the intraoperative phases. During the post-operative period there is still potential for significant complications because the patient’s body still hasn’t reestablished its physiological equilibrium. Complications after an appendectomy can include: peritonitis, pelvic abscess, subphrenic abscess, and ileus (Huether & McCance, 2012). Aside from post-op complications

Epiploic appendagitis (EA) is swelling and irritation of pouches (epiploic appendages) attached to the last part of the digestive tract (colon). These pouches contain fat and are attached to the outside of the colon by thin strands of tissue (stalks). This condition causes sudden lower abdominal pain.

While the range of reported accuracy (82% to 96%) for US in children has been acceptable, the sensitivity (44% to 100%) and the specificity (47% to 99%) have varied considerably; also, the visualization rates vary widely in the published literature, from a low of 22% to a high of 98% (6). From 98 patients that had appendicitis, ultrasound results were in favor of appendicitis in 63 patients (64.3%) and were suspicious for appendicitis in 14 patients (14.3%). Twenty One patients had normal study (21.4%) (

Other studies reported that, the age incidence varies between 7 to 65 years, the maximum incidence of acute appendicitis was found in age group of 11-20 years (45.45%), followed by age group of 21-30 years (25.45%) and then age group of 31-40 years. Approximately, 70% of the affected patients are in 2ndand 3rddecade of life [11]. Also others, found that the maximum incidence of 67% in 2ndand 3rddecade of life [12,13]. In our study, the age incidence varies between 12 to 47 years, the maximum incidence of acute appendicitis was found in age group of 21-40 years (56%), followed by age group of ≤20 years (28%) and then age group of 41-60 years (16%).Approximately, 84% of the affected patients are in 2ndto 4thdecade of life. Other

Griffin (2005) reports that most 'hospital acquired infections' (HAIs) are "largely preventable" and that surgical site infections (SSIs) "account for about 40% of all HAIs." (p.20) Griffin additionally notes that according to studies "surgical patients who develop SSI are twice as likely to die as those who don't. These patients are also 60% more likely to require an ICU admission, remain in the hospital twice as long, and have a 6 times higher rate of readmission that those with no infection." (Griffin, 2005, p.21) According to Griffin (2005) "appropriate use of prophylactic antibiotics is fundamental in preventing SSI and includes three core elements: (1) appropriate selection; (2) timing of the first dose; and (3) discontinuation postoperatively. (p.21) This is reiterated in the work of Stefansdottir, et al (2009) entitled "Inadequate Timing of Prophylactic Antibiotics in Orthopedic Surgery" which reports that prophylactic antibiotics are in important part of the preventive measures" following surgery to combat SSIs. (paraphrased) Kasteren, et al (2007) in the work entitled "Antibiotic Prophylaxis and the Risk of Surgical Site Infections Following Total Hip Arthroplasty: Timely Administration Is the Most Important Factor" reports that SSIs following "total hip arthroplasty can lead to prolonged hospitalization, increased morbidity and mortality and high costs." (p.921)