What Causes Appendicitis & How to Treat It

appendicitis we've all heard of it maybe some of us have even had it or known someone who's had it which is not unheard of because appendicitis is actually one of the most common causes of emergency abdominal surgery worldwide so we're gonna talk about what it is what causes it some of the symptoms that are associated with appendicitis how we even treat it and of course all the relevant and atomically awesomeness so let's get to it so let's start with what the appendix actually is the appendix actually has a longer name called the vermiform appendix bromoform just means worm-like appendix just refers to an appendage and the appendix is a worm like appendage off of this structure called the cecum now the cecum is part of the large intestine and we went over that in our digestive system video so if you want a little review about that go ahead and check that other video out but I'm going to show you that on the current cadaver right here so go ahead and take a look you can see we've removed all the skin from the anterior body wall or the front of the abdomen here this is about where the belly button would be coming down here is the pubic bone and then so this is the left side of the abdomen the right side of the abdomen the appendix is on the right lower quadrant or the right lower portion of the abdominal cavity now if I reflect this away you can see there's the abdominal muscles reflected away and we come immediately to this structure called the greater omentum this is a really cool structure it's just this apron that drapes over the intestines and I shouldn't say just this we're going to learn some cool functions with this and even how it can apply to appendicitis later in this video but let me reflect it away and you can actually see all the small intestines that I'm lifting up here and they're attached to this yellowy tissue called the mesentery that's actually holding them to the back of the body wall here but the appendix is over here on this side that's what I need to do is actually lift up the cecum this is that structure that I was saying the appendix comes off of and you can see this little worm-like structure that I'm pulling out right here and that's the vermiform appendix it's about two to three inches long this is a structure that we're going to talk about getting inflamed or infected here so a lot of the times people will say what is the function of the appendix a lot of people will refer to this as a vestigial structure or a vestigial organ like a vestige of time or essentially it's a structure that has lost some of its functionality through evolution now it's not necessary but it does perform some potential some functions and when we say it's not necessary people get the appendix removed all the time and they do just fine but it doesn't mean it doesn't do anything at all now we do know that the appendix has a lot of lymphatic nodules in it and those are just conglomerations of white blood cells and what that does is it helps monitor bacteria and potential pathogens that are potentially coming in for the large bowel now there's also some theories that the appendix actually has some a storehouse or a safehouse for what we call good bacteria or normal flora so in situations where people have major diarrhea dysentery some people mentioned cholera or even major major bouts of diarrhea that clears out the stool and even some of the good bacteria it's theorized that some of that good bacteria can be replenished in that from that little teeny-tiny appendix that's not quite as effective from those major bouts of diarrhea so when the appendix becomes inflamed we refer to it as appendicitis but what initiates this process well we have to understand that the appendix even though it's a small little structure it's actually still a tube meaning it's hollow inside what happens is the inside of the appendix or the lumen which if you compared that to a hose like a garden hose the inside of the hose is referred to as let's say like a lumen now that lumen of the appendix would be obstructed and it can get obstructed by a number of different things it can get obstructed from fecal ists which is essentially clogged with poop and we also can get it obstructed with undigested or foreign material sometimes it gets inflamed from the lymphatics surrounding it and in fly mode an infective process where the lumen gets constricted because the wall literally gets inflamed and sometimes it can even be caused by tumors so once the obstruction of the appendix starts things are going to continue to progress because want you to imagine if there is a blockage inside of a hollow tube that's going to increase the pressure inside the tube and in this case the appendix it's also going to put pressure on the walls of the tube think of the walls of a hose in this case and inside the walls of the appendix there are little blood vessels and little lymphatic vessels that are being compressed if you compress those vessels one you don't get a good blood supply coming in and you also don't drain old blood out very well this will cause the appendix to get engorged inflamed and even enlarged and that's when you'll start to get pain signals so those initial pain signals coming from the appendix they're referred to as visceral pain now visceral just means pertaining to an internal organ now our body isn't great at localizing visceral pain what I mean by that is oftentimes visceral pain will kind of be like a referred pain we'll feel the pain in an area where the problem actually isn't occurring for example we know that the appendix is in that right lower quadrant here but a lot of the time people will initially feel pain or at least the initial pain from appendicitis around the bellybutton kind of the central hard to localize pain that's in the center or Perry umbilicals what they referred to it as now as the pain gets worse or the inflammation of the Appendix gets worse we'll start to get other tissues involved that are much better at localizing that pain signal so to understand how the pain starts to become more localized with appendicitis we have to jump back and talk about how we mentioned appendicitis can progress and progress and get worse now we started with obstructing the tube and then due to that obstruction we increased pressure on that tube in the appendix started to get inflamed and gorged the next thing that tends to happen is bacteria starts to grow out of control and invade the actual surrounding wall of the Appendix as that happens the wall of the Appendix gets more inflamed and even the surrounding tissues get inflamed now let me actually show you the tissue that I'm talking about here so if I again reflect the abdominal body wall out of the way and you take a look at this glassy tissue right here this is referred to as the parietal peritoneum now the parietal or the peritoneum is a serous sac that surrounds the actual abdominal cavity and the intestines and it lines the inside of the wall here now we'll do some more specific videos on this stuff but for right now I want to mention that this stuff is actually innovated by different types of nerves and they're called somatic nerves or we'd have somatic sensation in this case now somatic sensation is much more pinpoint accurate that's the type of pain that you feel and say like muscles or on the skin when you get cut and these don't tend to refer as much as a visceral pain now take a look here if I point here and I lay it down here I want you to imagine the appendix here getting inflamed and this tissue over the top of it also getting inflamed and if that tissue over the top of the appendix also gets inflamed that can start to localize the pain to that right lower quadrant but again it takes a little while for that to actually progress now there are some exceptions to this there are some people who won't feel that right lower quadrant pain and let's do too often the appendix being in a slightly different orientation than say the average orientation of the appendix so what are the classic symptoms of appendicitis well abdominal pain which we've already covered which often will go to the right lower quadrant you also will see anorexia which people just don't feel like eating when they have appendicitis also nausea vomiting that's kind of that classic presentation of appendicitis people will often also have a low-grade fever of around like 101 now it's always nice when you're a clinician and people fit into that classic box of this symptom this symptom in that symptom but not everybody will present just perfectly like that some people will often have other symptoms like indigestion flatulence don't be ashamed it's appendicitis you can't control that right also there's Bala regularities in some patients even diarrhea and just that general feeling of like aches and just not feeling well like you're ill so finally how do we treat appendicitis well those of you who have had experience with appendicitis are probably gonna say yank that thing out of there and that is correct that is still the current standard of treatment in the United States is what we call an appt Dec to me removal of the appendix but did you know that you can actually treat appendicitis with antibiotics whenever I tell people that I always get this response of what conspiracy what's going on why are we doing all these surgeries and the answer to that question is that even though the rates of curing appendicitis are pretty favorable with just antibiotic use in some studies up to 90 percent of people responded favorably to antibiotics there's still that 10% and we don't know when you have a patient in front of you if they are going to respond well to the antibiotics and so are we putting people at risk for a rupture of the Appendix another risk is that 30% of people treated with antibiotics and those studies tend to come back within five years with another episode of appendicitis and end up having to get the appendix removed anyway and because of that and with the success of laparoscopic surgeries we've chosen to essentially say okay we're gonna still help this overall decrease the risk of complications and future complications with appendicitis just by simply removing it so the last thing we need to talk about regarding appendicitis is one of the complications that people will often ask about and that is what if the appendix ruptures or perforates so let's take a look at the cadaver to kind of help us with that story now if you take a look at again the abdominal cavity and I'll pull up the appendix here this little guy if it potentially ruptures that could spread a fecal matter bacterial pus and just that infective material now there's a couple of different scenarios that can happen in this situation one is called free perforation what that means is that infective material or the material coming out of the appendix can freely move throughout the whole abdominal cavity and that is more of a serious complication and they will actually want to operate pretty quickly with that also if the patient is showing signs of sepsis or unstable they'll also immediately operate now not all patients are actually unstable when they present with a perforated appendix there's this really cool thing called the greater omentum that can actually drape over and actually contain the ruptured material or the ruptured appendix and so it doesn't spread throughout the whole abdominal cavity also other situations an abscess will form around that appendix and that abscess yes it's a collection of pus but it contains it in that localized region again now on imaging if the abscess is less than say three centimeters they'll go ahead and take them to surgery and do an appendectomy if the abscess is greater than 3 centimeters they'll actually do what's called a percutaneous drainage of the abscess which is just draining the abscess through the skin and they'll also put them on antibiotics if they get clinical improvement they'll actually wait to do the appendectomy tell they're done with an antibiotic course and as long as they keep improving clinically as always we hope that gave you a better understanding appendicitis and the anatomy that's involved with appendicitis and if you want to continue staring at the appendix you can see a little appendix coming off this little artwork from codex and atomic Asst these guys are even anybody a discount who uses our discount coupon so if you guys want to take a look at them we'll put the link in the description and as always please give us comments and feedback of anything else that you want to see we love reading through those and love your guys and suggestions [Music] you

Channel: Institute of Human Anatomy

Views: 724,067

Keywords: institute of human anatomy, appendicitis symptoms, institute of human anatomy tik tok, appendicitis, appendix removal, appendicitis signs, appendicitis symptoms video, appendicitis symptoms and signs, appendicitis causes, appendicitis pain area, appendectomy, abdominal pain, appendicitis symptoms and treatment, appendicitis symptoms and cure, appendix, appendicitis symptoms right hip pain, appendicitis signs causes, appendicitis signs and symptoms, appendectomy with abscess

Id: A468P2u2_b0

Length: 12min 37sec (757 seconds)

Published: Tue Apr 07 2020