An Appendix Abscess Via Laparoscopy
The appendix is a worm-like structure attached to the first part of the colon (a.k.a. large intestine), called the caecum. It’s function is to assist in defense of the body against infection, much as tonsils do. When the appendix is inflammed, it called an acute appendicitis.
An acute appendicitis as seen via a laparoscope.
What happens to an acute appendicitis if an appendicectomy is not performed at this point in time? There are a few scenarios that may follow. The appendix may burst into the general abdominal space (called the peritoneal cavity). This is the worst scenario as the patient will become very sick, very quickly. Alternatively, a fat-laden structure in the abdomen (called the omentum, a.k.a. “the abdominal policeman”) may move to the the appendix are and wrap up the appendix to prevent it from bursting. This results in an appendix mass (=lump). Eventually, the appendix may be “eaten up” by the body defense mechanism.
There is a third scenario. If the appendix bursts inside this walled off area and pus collects, then an appendix abscess occurs. This is different from an appendix mass because there is active inflammation and pus formation going on. The patient is in persistent pain and may be having fever. Appendix abscesses are usually treated by surgery to remove the remnants of the appendix and drain the pus. The patient will usually require a course of antibiotics.
An appendix abscess as seen via a laparoscope. The yellowish “curtain-like” structure sloping to the upper portion of the photo is the omentum (the “abdominal policeman”). Creamy pus can be seen leaking out from the abscess, at the tip of the instrument on the upper left quadrant of the photo.
eh , how do u make out the appendix ar?….esp when u do a lap..any identification structure?…i see the pic oso..kenot make out la..
When we are doing it, we have the advantage of moving pictures; not static ones, so it’s much easier. Plus, we can hold the appendix with the instrument and trace it to its base. On this photo, you have to take my word for it lah. See the next post for a photo of the appendix highlighted with a yellow line