To be, or not to be......that is the appendix!

Discussions of the best (or worst) equipment to have on hand for use in the event of an injury during an emergency.

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Re: To be, or not to be......that is the appendix!

Postby duodecima » Sun Aug 05, 2012 9:51 pm

LowKey wrote:I'm sure there is a very good reason not to do so...I'm just not sure what it is. Aside from the problem of actually hitting the mark with a needle, that is.


That's actually a large problem. The appendix is this little "worm like" (origin of the latin name "vermiform appendix") tag, off the very first part of the colon, right where the small intestine empties in. It can be in any relationship to that piece of the colon - dangling straight out the bottom, stuck up to the side, or around behind the cecum (that part of the colon.) The colon and small intestine are, necessarily, RIGHT THERE. There's something (frequently a small hard piece of feces) plugging up the opening to the appendix, which is allowing the infection to progress and collect pus, which then makes the appendix get bigger. By bigger, I mean 6-30 mm. So we're talking about trying to hit a squishy, mobile thing which is anywhere from a half a centimeter to 3 cm wide which is right up next to a lot of intestines. Poking holes in intestines is a great way to CAUSE peritonitis. Also, let's say, hypothetically, you somehow have xray vision, and you can reliably hit the appendix with a needle from outside the belly - you suck out the pus that's there. There's still that poke hole, which may leak more pus. Or it may seal, and the pus recollect, so you're back where you started.

When the old texts talk about draining appendiceal abscesses, they're talking about making a hole in the belly to let the pus that's collected from a ruptured appendix out. (And the hole is left open a while...)You'd leave a drain in a while, if you had a drain. (And drains are a potential source of infection, not a huge hazard but non-zero. We use closed, sterile collection devices, sometimes with oneway valves...)

Erie quiet wrote:is your appendix bursting the main problem?
if your appendix doesn't burst ( drained? )... is it still as serious of an issue?

Fair question. Answer is yes, an unburst appendix is still very serious. We try (hard) to take 'em out before they burst, so those folks who show up febrile, hurting, and sometimes puking are that sick from an appendix that hasn't burst. Untreated, I think the risk of eventual perforation or sepsis (it doesn't burst but the infection gets into the blood stream, goes all over, and makes you sick in many other ways :gonk: ) is high. I can't quote numbers on that. It's not considered ethical just to sit back and let that happen to people to see what percentage do recover without any treatment. (Altho, apparently with the addition of IV antibiotics, there's a bunch of folks who do get better without bursting... So it's really NOT a crazy thing to wonder about.)

Erie quiet wrote:also related...more wise words from the stream of intestinal destruction :oops:
"Medicine in apocalypse is going to?.... FUCKING SUCK"

QFFT! (quoted for fucking truth!)
What course did you take/where was the river of intestinal destruction, it sounds fun?
Krustofski wrote:Dude, you're an open system which has energy pumped into it at least once a day. Entropy doesn't stand a chance. Plus, all living things are thermodynamically unstable anyway, we're held together by pure kinetics. You're not special. Um... what I'm trying to say is: Happy Birthday.
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Re: To be, or not to be......that is the appendix!

Postby Rebel Pariah » Sun Aug 05, 2012 11:47 pm

duodecima wrote:What course did you take/where was the river of intestinal destruction, it sounds fun?


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:oops: ... :vmad:
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