3.Appendicitis

VOCABULARY and PRONUNCIATION

Task 1. Read out.

 READING and SPEAKING

Task 2. Warm-up discussion.

What is appendicitis? What is thought to be the cause of appendicitis? How is appedicitits treated?

Task 3. Read the text and answer the questions.

Appendicitis usually presents as an acute inflammation of the appendix. It can lead to perforation with subsequent peritonitis. The inflammation can be caused by an obstruction such as an indurated mass of feces, a foreign body in the lumen of the appendix, parasitic infection, fibrous disease of the bowel wall, or adhesions.

Appendicitis is usually seen in teenagers and young adults and found more frequently in males.

The most common representation of acute appendicitis is constant pain that develops in the right lower quadrant of the abdomen at McBurney’s point. However, initially it usually begins as an intermittent

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pain in the mid abdomen that subsequently localizes in the lower right quadrant. The patient tends to bend the knees in order to prevent tension of the abdominal muscles and decrease the pain. The pain of acute appendicitis is aggravated by walking and coughing.

The patient usually develops a low-grade fever, nausea, vomiting, elevated white blood count, rebound tenderness, decreased or absent bowel sounds, and rigid abdomen. Besides, the patient may have board-like rigidity of the abdomen.

The most common complication of appendicitis is peritonitis, inflammation of the peritoneum. When peritonitis begins, following the rupture of the appendix, the patient may have a sudden relief of the pain. The patient has increased fever and chills, progressive abdominal distention and abdominal pain, tachycardia, tachypnea, restlessness.

Another complication is appendiceal abscess. Abscess usually occurs 2-6 days after the onset of the disease. In this case, a tender mass in the lower right quadrant or pelvis will be palpated.

In elderly patients, the abdominal findings may be absent or unimpressive, until perforation of the appendix occurs. It may also be difficult to make a diagnosis in a pregnant woman or an obese.

Typical findings in acute appendicitis normally occur when the appendix occupies the iliac fossa. If the appendix extends over the pelvic brim, the abdominal signs may be minimal, with tenderness being elicited only on rectal examination. Patients with a retrocecal appendix may have poorly localized abdominal tenderness. If the appendix lies high and lateral, maximal tenderness may be present in the flank.

Treatment of appendicitis is appendectomy, surgical removal of the appendix.

1.What is the most common representation of acute appendicitis?

2.How do patients with appendicitis describe the pain?

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3.List some objective and subjective symptoms the patient may complain of.

4.Describe peritonitis as a complication of appendicitis.

5.When examining a patient with peritonitis, what physical findings is the doctor likely to see?

6.When does appendiceal abscess usually occur?

7.What are the clinical findings in elderly patients?

8.How can a surgeon treat acute appendicitis?

Task 4. Are these statements true (T) or false (F)? If the statement is false, correct the statement.

1.Appendicitis is a chronic inflammation of the appendix.

2.Constant pain develops in the right upper quadrant of the abdomen at McBurney’s point.

3.Appendicitis can be complicated by an inflammation of the peritoneal cavity.

4.In an elderly patient the symptoms of acute appendicitis are

severe.

5.Conservative treatment is possible in some cases of appendicitis.

GRAMMAR

Task 5. Find Past Participles (Partciple II) in the text paying attention to their translation and give examples.

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