Sometimes the appendix is “white”.
A diagnosis of acute appendicitis is made on clinical grounds. That means that the surgeon takes a history and examines the patient and comes to a diagnosis of acute appendicitis. Investigations (tests) are additional procedures that are used to rule out other diagnoses, that is to make sure that the cause of the pain is not something else, eg. urinary stone or infection, ovarian cyst, ectopic pregnancy, etc. Or to assist to make a diagnosis when there is doubt. The treatment for acute appendicitis is appendicectomy (removal of the appendix).
A “white” appendix
Occasionally, another explanation for the pain may be found during the operation. The appendix is actually not inflammed (not appendicitis). We call it “white” (as opposed to a “red” inflammed appendix.) A common cause of pain in the right lower quarter of the abdomen, which mimics appendicitis, is a ruptured right ovarian cyst. The blood and fluid from the cyst causes pain similar to appendicitis.
An cyst on the right ovary.
So there’s the answer.
Looks like a bulging eyeball to me..;p Erm, eye got poked so red eyeball..hehe
Thanks for the easy-to-understand layman language you use (or try to ) to explain the medical conditions and the life-like pics… really appreciate it and find it educational! Keep posting!
how come can become white?
Oh yah… we are organising ‘Together-Gather’ Year End Bloggers Party on 30 Dec 2006. U want to join?
i wan to join….but i m half a blogger nia..*penumpang oni…can go ar?…jom bernard..kita gi sama sama nak?..
Eskay, yup. It does look like one doesn’t it?
Jan, thanks for the encouragement. I shall.
Kenny, white (pearly white) is it’s normal colour. In other words, it’s a normal appendix.
Together-gather party eh? Sounds like fun! But I’m not sure whether I can go to KL leh. Where will the venue be?
Venue will be at Federal Hotel, Bukit Bintang there.
wah federal hotel! nice. near pudu as terminal right?
eve and Kenny, it would be great to join y’all but i can’t say yet. Federal Hotel is a good location, central.
This doesn’t look like ruptured ovarian cyst to me (may be you have the pre-rupture photo). It looks like a folicle about to ovulate. From the picture, it is too small to be a cyst. A cyst should be 5 cm and above.
poor doctor, welcome! I was hoping for someone to turn up and discuss on this topic. Hehe.
actually, there was blood and cyst fluid in the pelvis at the time of entry already. It probably leaked. There were other small ones on the left side too. This was the biggest. Perhaps the one that ruptured was not seen, but this one hasn’t ruptured yet.
i agree, it’s physiological. Perhaps some info for the other readers (from Wikipedia, nothing too hi-tech):
Ovarian cyst, will they impose any problem to the body? Is it normal that all women have it? If yes, any special medical attention?
hoiling, some cysts are physiological (synonym: normal function). Others are pathological (abnormal). They deserve to be seen and managed by the gynaecologist.
true, appendicitis is a clinical diagnosis. when i was a houseman in the surgical unit, i used to help the MO do appendicectomies. sometimes we come across a “white appendix” & what the MO would do is to rub the appendix till it looked inflamed, because the anaesthetist often make cynical remarks when he sees a normal-looking appendix.
Hahhahaha… they sometimes do, don’t they? Especially if you push for the case at 2 o’clock in the morning
Histopathological report : hyperaemic appendix. Hehe.
Like that one ah? Hmmm… come to think of it, oklah, better rub it till red, otherwise might have to go thru a really tough time from the aneasthetist the next time u want to push in another appendicitis case, hor.
Does it means that each time u go in and if u find a white appendix, u’ll still cut it? afterall, that fellow there tak byk kegunaannya?
CSH,
yes, the appendix, whatever its state during the operation, is removed every time a diagnosis of appendicitis is made for 2 impt reasons:
1) the appendix is not an essential organ, therefore it shd be removed lest it gets infected in the future;
2) more importantly, if it is not removed, the next time it is infected, the doctor may not think the appendix is the cause becos when he/she sees the scar on the abdomen, he/she may think the appendix has been removed previously.
Thanks doc for explaining :-). Couldn’t have said it better.
Wow! Truly eye-opening. Thanks for sharing them.
Thanx, doc.