Definition and Overview

The appendix is a thin tube located at the beginning of the colon where the large and small intestines join. Many doctors believe that it does not have any function in the human body. Some suggest that early human beings needed it to digest tough leaves and bark. Removing the organ through surgery causes no short or long-term health problems.

Just like other organs, the appendix can develop a number of disorders. The most common problem is infection, which can cause it to swell and burst. The organ can also develop abnormal growths.

Causes of Condition

Below is a list of disorders of the appendix and their corresponding causes:

  • Appendicitis - This is the most common disorder that affects the appendix. It develops when blood flow to the organ is blocked or cut off. Without enough supply of nutrients and oxygen from the blood, the organ can die. This also increases the risk of bacterial infection inside the organ. This leads to the formation of pus.

  • Tumours - Tumours can form in or around the organ if healthy cells in the area begin to change and grow out of control. These cells can then accumulate and form an abnormal growth. Benign or non-cancerous growths often go undiagnosed because they cause no symptoms. They are often found when the patient undergoes imaging tests for another unrelated medical condition.

  • Cancer - The appendix can also develop cancer. This occurs when abnormal cells form a tumour and spread to other parts of the body. These growths can start on the appendix wall, at the base of the organ, or around the organ.

Key Symptoms

Patients with a swollen appendix often suffer from pain around the bellybutton. The pain can also be felt in the lower right side of the abdomen. Other symptoms include abdominal swelling, vomiting, and diarrhoea. Patients may also experience nausea and loss of appetite. Many also have difficulty passing gas. If the organ ruptures, the patient will have a high fever and infection.

The symptoms of appendix tumours are mostly the same as appendicitis. This is the reason why some people with this condition are misdiagnosed. However, cancer of the appendix causes additional symptoms. These include ascites, increased size of waistline, and infertility.

Who to See and Types of Treatments Available

Disorders of the appendix are treated by gastroenterologists. These are doctors who specialise in disorders and diseases of the digestive system.

Patients showing signs and symptoms listed above are often suspected of appendicitis. To make a diagnosis, the doctor will order blood and urine tests to look for signs of infection. These tests also help rule out other possible causes of the patient’s symptoms. These include kidney stones, urinary tract infections (UTIs), and ectopic pregnancy.

If the tests detect any abnormality, the doctor will order imaging tests. These may include a CT scan, x-rays, and ultrasound. These tests create images of the abdominal organs. They allow doctors to easily spot any abnormalities that may cause the patient’s symptoms.

Imaging tests can also confirm or rule out the presence of tumours. If an abnormal growth is detected, the doctor will perform a biopsy. For this procedure, a small tissue sample is taken for further study. If the tumour is benign, the doctor will treat the condition by removing the appendix through surgery.

If the tumour is cancerous, other tests will be performed to determine its size and location. The doctor will also conduct tests to see whether or not it has already spread to nearby or distant organs.

A swollen appendix is removed if appendicitis is confirmed. However, if the organ has formed an abscess, the surgeon will delay the procedure. He or she will first drain the pus and fluid that has accumulated in the organ. This helps lessen the risk of widespread infection. The removal of the organ can then be scheduled within two to three months.

If the appendix has already ruptured, the surgeon will go ahead and perform the surgery right away. If the surgery is delayed, bacteria and other harmful substances from the appendix can spread within the abdominal cavity. This is a cause for concern because it can be very difficult to treat.

An appendectomy can be performed using traditional open surgery. In this method, an incision is made in the abdomen. The procedure can also be performed laparoscopically. This is a minimally invasive method in which a tube with a light source and camera is inserted into small incisions.

The first method is used if there is abscess and the appendix has burst. It requires one large incision in the lower right side of the abdomen. This gives the surgeon easy access to the appendix and an easier way to clean the abdominal cavity. The resulting wound is then closed with stitches.

The laparoscopic method requires only a few small incisions in the abdomen where the laparoscope and other tiny surgical instruments are inserted. The camera takes images of the appendix and surrounding structures. These images are then displayed on a screen to guide the surgeon as he or she performs the procedure. This method is associated with reduced risks and faster recovery time.

Appendix tumours are also removed with surgery. Surrounding structures where cancer cells have spread must also be removed. In some cases, this means the removal of the colon next to the appendix or the peritoneum. The surgery can be followed by chemotherapy and/or radiation therapy depending on the stage of cancer. These therapies are used to kill any remaining cancer cells. They can also be used to relieve symptoms for patients with advanced appendix cancer that can no longer be cured.

The prognosis for patients with appendix cancer depends on the stage of their condition and how soon they received treatment. The majority of people who have small, localised tumours are cured by surgery. Those whose cancer has spread to regional lymph nodes have only 78% 5-year survival rating. This number goes down to just 32% for those whose cancer has spread to distant parts of the body.

References:

  • Higa E, Rosai J, Pizzimbono CA, Wise L. Mucosal hyperplasia, mucinous cystadenoma, and mucinous cystadenocarcinoma of the appendix. A re-evaluation of appendiceal “mucocele”. Cancer 1973; 32:1525.

  • Definitions and facts for appendicitis. https://www.niddk.nih.gov/health-information/digestive-diseases/appendicitis/definition-facts

  • Amy Hunter “How Your Appendix Works” 4 June 2008. HowStuffWorks.com. https://health.howstuffworks.com/human-body/parts/appendix.htm 15 November 2017

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