ABSTRACT
This chapter describes the symptoms and signs in patient with appendicitis. It explains how to perform a laparoscopic appendicectomy. The laparoscopic appendicectomy may be used in young female patients, where the diagnosis is uncertain and imaging has failed to exclude a gynaecological cause. In these circumstances, laparoscopy can be both diagnostic and therapeutic. The chapter provides a discussion on the causes of generalised peritonitis. These include acute appendicitis, perforated peptic ulcer, perforation of sigmoid diverticulitis, rupture of ectopic pregnancy, acute pancreatitis, perforation of inflamed gallbladder, perforated colon due to carcinoma, and primary peritonitis. Bacteroides, Escherichia coli, Clostridium perfringens, Pseudomonas and Klebsiella are the commonest causative organisms responsible for peritonitis. Pneumococcus is the organism responsible for primary peritonitis. The chapter provides a comparison between the laparoscopic procedure with an open operation.
