EMERGENCIES: APPENDIX, STOMACH ULCERS AND BOWEL OBSTRUCTION
At a glance
An infected appendix on the verge of bursting, ruptured or bleeding ulcers, and bowel obstructions are emergencies that require medical intervention immediately to prevent any severe health complications.
When these conditions are not treated, the implications involved include:
- Bowel obstruction occurs due to a blockage as a result of the mechanics of the internal structures. A blockage in one of the bowel segments causes fluid rich in electrolytes to seep into the bowel. Even when the bowel is not obstructed but for some reason does not work adequately, functional problems regarding misplacement of electrolytes occur. A blockage can limit blood flow in the intestines—poor blood supply results in the death of the intestinal wall.
- Pain at the bottom of the right side of the abdomen is a sign of appendicitis. Appendicitis occurs due to an inflamed appendix. Inflammation only gets worse, which gives rise to severe, throbbing pain. The only way to treat appendicitis is at the hospital and with surgical intervention. A small subset of patients may be treated with antibiotics alone. However, surgery remains the gold standard.
- Peptic ulcers are tiny open lesions that form along the stomach lining and walls of the small intestine, causing intense abdominal pain. Peptic ulcers arise due to a bacterial infection caused by H. pylori.
How to prepare for the procedure
A physical exam will assess the level of pain you are experiencing, mainly when dealing with appendicitis. Various tests were carried out to rule out other illnesses displaying similar symptoms of appendicitis, including problems with the gallbladder, a urinary tract infection, and gastritis. These are emergency conditions and will soon be prepared for surgery based on the findings of your examination.
When dealing with bowel obstruction, your surgeon carries out a series of tests to assess the level of impact of anything other than faecal matter. A physical exam is carried out to check for unusual lumps or gas and bowel motility.
Prior to treating a peptic ulcer, your doctor considers your medical history first and then performs a physical exam and commences laboratory testing to check for traces of H. pylori bacteria. An endoscopy is a means of removing tissue for biopsy and is quite common among people who experience a variety of upper gastrointestinal symptoms, including heartburn, reflux, abdominal pain and vomiting.
There are certain protocols to adhere to before an endoscopy. Afterwards, you can expect a mild sore throat. Some bloating, gas, abdominal discomfort and cramping are to be expected if the air is pumped into your stomach. You may also experience anaesthesia associated side effects such as nausea. If you have a bleeding ulcer, Dr Maraj will first attempt to stop the bleeding endoscopically.
What emergency procedures to treat life-threatening conditions involve
- An appendectomy can be performed openly or laparoscopically and entails the removal of a diseased appendix.
- Bowel obstruction surgery involves and resection of diseased bowel portions and reattachment of the remaining parts(anastomosis), or the placement of a colostomy bag.
- Antibiotics and anti-acid medications are prescribed to treat H. pylori bacteria causing peptic ulcers. Follow-up endoscopy is done to check the status of the ulcer after antibiotic treatment.
- A ruptured ulcer will be fixed by sutures and an omental flap via laparotomy. If the bleeding is serious, you may require an emergency laparotomy to stop the bleeding.
What to expect post-procedure
These are all surgical emergencies. You are likely to be admitted to ICU or high-care. Feeding will be escalated as per your recovery. You will receive antibiotics and intravenous fluids in the interim. A physiotherapist and dietician will be involved in your care. This is merely a basic guide; Dr Maraj will be able to provide you with further information should you need it.
Risks & complications
Guidelines and protocols are followed to prevent complications. Complications include infection, bleeding, deep vein thrombosis and pulmonary embolism and those due to the anaesthetic used. While this is a common and generally safe procedure, complications may still occur.
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