MISDIAGNOSIS OF APPENDICITIS

What is the Appendix?

The Appendix is a 3.5 inch-long tube of tissue that extends from the large intestine. The appendix has no known function. One theory is that the appendix acts as a store for good bacteria, “rebooting” the digestive system after diarrhoea.

What is Appendicitis?

Appendicitis is an inflammation of the Appendix.

Doctors are not sure what causes appendicitis, but it seems linked to the appendix becoming blocked often by infection, stool, a foreign body, or cancer.

Almost all cases of appendicitis are treated as medical emergencies, requiring surgery.

An inflamed appendix will eventually burst, or perforate, causing infectious materials to be released into the abdominal cavity. This can lead to peritonitis, a serious inflammation of the abdominal cavity’s lining (the peritoneum) that can be fatal unless it is treated quickly with strong antibiotics.

Sometimes a pus-filled abscess (infection that is walled off from the rest of the body) forms outside the inflamed appendix. An abscessed appendix can perforate or explode and cause peritonitis.

What are the symptoms?

The main sign of appendicitis is pain, which usually starts in the middle of the abdomen and initially may come and go but within hours becomes constant and severe and moves towards the lower right side over the appendix. Pressing on this area, coughing, moving or walking may all make the pain worse.

You may also experience other symptoms, including:

• feeling sick (nausea)
• being sick
• loss of appetite
• diarrhoea
• constipation
• passing more urine than usual
• Painful urination and difficulty passing urine
• Inability to pass wind
• a high temperature (fever) and a flushed face
• Occasionally, the symptoms do not follow the pattern described above. For example  the pain may develop more slowly over a period of days or weeks, affecting different areas of the abdomen back, or rectum.

.Appendicitis can be confused with other conditions, such as:

• gastroenteritis
• severe irritable bowel syndrome (IBS)
• constipation
• bladder or urine infections
• Crohn’s disease
• pelvic infection

In young women, these symptoms can sometimes have a gynaecological cause, such as an ectopic pregnancy or menstrual pain.

When to get medical help

The NHS recommends that if you are experiencing abdominal pain that’s gradually getting worse you should contact your GP or local out-of-hours service immediately. If these options aren’t available, call NHS 111 for advice.

However, any condition that causes constant stomach pain requires urgent medical attention.

Do not eat, drink, or use any pain remedies, antacids, laxatives, or heating pads, which can cause an inflamed appendix to rupture.

You should call 999 for an ambulance if you get a pain that suddenly becomes worse and spreads across your abdomen. These are signs your appendix may have burst.

How is appendicitis diagnosed?

A doctor will usually ask you to describe your symptoms, how they started and how long they have lasted. They will feel the abdomen to identify the location of the pain and feel for any swelling. Usually, if appendicitis is suspected, an urgent admission to hospital will be arranged.

Tests will be carried out such as blood and urine tests, ultrasound or CT scans. These will be used to identify and locate any inflammation or infection in the abdomen.

How is appendicitis treated?

There is some research showing that treatment of acute appendicitis with antibiotics may eliminate the need for surgery in certain cases. However, surgery to remove the appendix, which is called an appendectomy, is the usual treatment for appendicitis to avoid the appendix rupturing and causing peritonitis. Surgery will be carried out under a general anaesthetic.

If the appendix has formed an abscess, two procedures may be needed: one to drain the abscess of pus and fluid, and then one to remove the appendix.

The operation to remove the appendix is usually carried out using keyhole (laparoscopic) surgery with a general anaesthetic. The operation usually lasts about an hour. The appendix will be cut off from the bowel and the hole will be closed with stitches.

If the appendix or an abscessed appendix has ruptured, this will cause infection to spread across the abdomen (peritonitis). Open surgery may then be needed to wash out the abdomen and remove any pus / infection.

Symptoms to look out for after Appendectomy

After an appendectomy, you should call your GP, the hospital or dial 111 if you have:

• Uncontrolled vomiting
• Increased pain in your abdomen
• Dizziness/feelings of faintness
• Blood in your vomit or urine
• Increased pain and redness in your incision
• Fever
• Pus in the wound

 

Medical Negligence

 

You may have a claim for compensation if you have received negligent treatment connected with appendicitis. Examples of circumstances where there may be a claim for compensation include where:

• infection is undiagnosed which delays recovery time or causes death.
• appendicitis is left undiagnosed for too long causing unnecessary discomfort, suffering and pain for the patient.
• further surgery is required due to failings in the first or second operations.
• appendicitis is diagnosed but there is a failure to act quickly enough resulting in the appendix bursting.
• Inadequate or no pain relief is given.
• after care is inadequate or insufficient.
• damage to other organs is caused during appendectomy surgery.
• There is a failure to correctly treat the appendicitis leading to another medical issue.