I
appendage
An additional piece of
tissue
that is
attached to a main structure. An auric-
ular appendage is a small tag of tissue
attached near the ear that may be pre-
sent from birth.
appendicectomy
Surgical removal of the appendix to treat
acute
appendicitis
(inflammation of the
appendix).
WHY IT IS DONE
Appendicectomy is performed to pre-
vent an inflamed appendix bursting and
causing
peritonitis
(inflammation of the
peritoneum, the lining of the abdomi-
nal cavity) or an abdominal abscess.
HOW IT IS DONE
The two methods of appendicectomy
are conventional appendicectomy and
minimally invasive surgery.
Conventional
surgery involves making a hole in the
abdominal wall that is large enough for
the surgeon’s instruments and finger-
tips to be introduced. In minimally
invasive surgery, three or four small
holes are made in the abdominal wall; a
laparoscope (viewing instrument) that
incorporates a video camera is inserted
into one of the openings, and instru-
ments and suction tubes into the others.
In both types of operation, the appen-
dix is identified, clamped, tied off at its
base, and removed.
If the appendix has burst, the infected
area of the abdominal cavity is washed
out with saline and drained via a tube
inserted
into
one
of the
incisions.
Antibiotic drugs may also be given to
prevent peritonitis.
COMPLICATIONS AND OUTLOOK
Possible complications are infection of
the incision wound, an abscess at the
site
from
which the
appendix was
removed, or localized peritonitis.
In the absence of complications, nor-
mal physical activities can usually be
resumed within two to three weeks.
appendicitis
Acute inflammation of the
appendix
(a
narrow, finger-shaped tube that branches
off the large intestine), which is a com-
mon
cause
of abdominal pain and
peritonitis
(inflammation of the lining
of the abdominal cavity).
CAUSE AND SYMPTOMS
The cause of appendicitis is usually not
known, but the condition is sometimes
caused by obstruction of the appendix
by a lump of faeces. The closed end of
the appendix beyond the obstruction
APPETITE, LOSS OF
becomes inflamed, swollen, and infec-
ted. This may lead to
gangrene
(tissue
death) in the appendix wall, which may
perforate (burst).
The first symptom is usually vague
discomfort around the navel. Within a
few hours, this develops into severe,
more localized pain, which is usually
most intense in the lower right-hand side
of the abdomen. Symptoms may differ
if the appendix is not in the most com-
mon
position.
For
example,
if the
appendix impinges on the ureter, the
urine may become bloodstained.
DIAGNOSIS AND TREATMENT
Diagnosis may be difficult because the
symptoms of appendicitis are similar to
those of many other abdominal disor-
ders. Sometimes a
laparotomy
(surgical
investigation of the abdomen) is neces-
sary in order to confirm or exclude a
diagnosis of appendicitis.
The usual treatment for appendicitis
is
appendicectomy,
which is often per-
formed endoscopically
(see
minimally
invasive surgery
).
COMPLICATIONS
If treatment is delayed, an inflamed
appendix may burst, releasing its con-
tents into the abdomen. At this point,
the pain ceases abruptly, but the perfo-
ration leads to peritonitis.
In some
cases, the omentum (fold of periton-
eum that covers the intestines) envelops
the inflamed appendix; this prevents the
spread of infection but may result in a
localized
abscess
around the appendix.
appendix
A small, narrow tube that projects out
of the caecum (the first part of the
colon) at the lower right-hand side of
the abdomen. The appendix may lie
behind or below the caecum, or in
front of or behind the ileum (part of
the small intestine).
The appendix has no known func-
tion, but it contains a large amount
of lymphoid tissue, which provides a
defence against localized infection. The
position of an individual’s appendix
partly determines the symptoms produ-
ced by acute
appendicitis
(inflammation
of the appendix).
appendix abscess
An
abscess
(a collection of pus) that
may form
after the
rupture
of an
inflamed appendix (see
appendicitis
).
appetite
A desire for food; a pleasant sensation
that is felt in anticipation of eating.
Appetite is distinct from
hunger,
which
is a disagreeable feeling caused by the
need for food.
Appetite, which is regulated by two
parts of the
brain
(the
hypothalamus
and
cerebral cortex), is learned by enjoying
a variety of foods that smell, taste, and
look good. It combines with
hunger
to
ensure that the right amount of a wide
range of foods is eaten in order to stay
healthy. (See also
appetite, loss of.)
appetite, loss of
Loss of appetite, known medically as
anorexia, is usually temporary and due
to an emotional upset or minor illness
.
Persistent loss of appetite may be a
symptom of a more serious underlying
physical or psychological disorder and
requires investigation by a doctor.
CAUSES
In adolescents and young adults, loss of
appetite may be due to
anorexia nervosa
(an eating disorder) or to
drug abuse
,
particularly of
amphetamine drugs
.
De-
pression
or
anxiety
may result in loss of
appetite at any age.
Possible physical causes of appetite
loss include a
stroke
(damage to part of
the brain caused by an interruption to
its blood supply), a
brain tumour,
or a
A
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