Appendicitis

Appendicitis is the commonest abdominal emergency, occurring mostly in people under 30 years old, though it can appear in people of any age. When considering appendicitis as a diagnosis, always ask the patient if he knows whether his appendix has already been removed, and look for the operation scar in the right lower abdomen area.

The illness usually begins with a combination of colicky abdominal pain, nausea, and perhaps mild vomiting. The pain is usually felt in the midline just above the navel or around the navel. Later, as the illness progresses, the pain moves from the center of the abdomen to the right lower quarter of the abdomen. The character of the pain changes: from being colicky, diffuse, and not well localized when it is around the navel, it becomes sharp, distinctly felt, and localized at the junction of the outer and middle thirds of a line between the navel and the front of the right hipbone. The patient usually loses his appetite and often feels ill.

Examine the patient. If he complains of sharp stabbing pain when you press gently over the right lower quarter of his abdomen and especially if you feel his abdominal muscles tightening involuntarily when you try to press gently, you can be fairly sure that the appendix is inflamed. The temperature and the pulse rate will rise as the inflammation increases.

Treatment

Once you suspect a patient has appendicitis get RADIO MEDICAL ADVICE and GET THE PATIENT TO HOSPITAL AS SOON AS POSSIBLE. Do not give a purgative.

 

If the patient can reach hospital within 4-6 hours, give him no food or liquid and no drugs, as he will probably require a general anaesthetic. Keep him in bed until he is taken off the ship. Keep a record of the patient’s temperature, pulse, and respiration, and send these and your case notes to the hospital with the patient.

If the patient cannot get to hospital within 4-6 hours, put him to bed and the temperature, pulse rate and respiration rate hourly. The patient should have no food, but can have drinks. Treat severe pain according to RADIO MEDICAL ADVICE.

Subsequent treatment

If the patient is still on board after 48 hours, he should be given some fluids such as milk, sweet tea, and soup until he can be put ashore.

Anyone who was thought to have appendicitis but seems to have improved should be seen by a doctor at the next port. Improvement is shown by diminution of pain and fall in temperature.

 

2. Answer the following questions

1. What signs and symptoms of minor abdominal conditions do you know?

2. What abdominal emergencies exist?

3. What are the symptoms of appendicitis?

4. What should be done if the patient on board a ship cannot get to hospital?

 

3. Remember the following expressions and make up dialogues using these expressions

Pains

1. Sudden pain – внезапная боль
2. Marked/pronounced pain – выраженная боль
3. Generalized pain – генерализованная боль
4. Нeadache – головная боль
5. Fasting pain – голодная боль
6. Gnawing pain – грызущая боль
7. Pressing pain – давящая боль
8. Burning pain – жгучая боль
9. Retrosternal pain – загрудинная боль
10. Tooache – зубная боль
11. Extending pain – иррадиирующая боль
12. Colicky pain – коликообразная боль
13. Piercing/stabbing pain – колющая боль
14. Aching/rheumatic pain – ломящая боль
15. Troublesome/excruciating pain – мучительная боль
16. Muscular/muscle pain – мышечная боль
17. Neuralgic pain – невралгическая боль
18. Girdle pain – опоясывающая боль
19. (Sudden) Acute pain – (внезапная) острая боль
20. Reflected pain – отраженная боль
21. Constant/persistent/continuous pain – постоянная/непрерывная боль
22. Paroxysmal/periodical pain – приступообразная/ периодически возникающая боль
23. Long-standing pain – продолжительнпя боль
24. Transient pain – проходящая боль
25. Throbbing pain – пульсирующая боль
26. Arching pain – распирающая боль
27. Cutting pain – режущая боль
28. Tightening/pressing pain – сжимающая боль
29. Severe/intense/violent/bad pain – сильная боль
30. Slight pain – слабая боль
31. Steady/lasting pain – стойкая боль
32. Shooting pain – стреляющая боль
33. Cramping/cramp-like/spasmodic pain – схваткообразная боль
34. Dull pain – тупая боль
35. Pains of unknown origin – боли неясного происходжения
36. Angina like pains, stenocardia like pains – боли, похожие на боли при стенокардии
37. Pain on defecation – боли при дефекации
38. Pains on urination – боли при мочеиспускании
39. Сhest pain – боль в груди
40. Stomach ache – боль в желудке
41. Abdominal pain – боль в животе
42. Painful breathing – боль во время дыхания
43. Back pain – боль в пояснице
44. Joint pain – боль в суставах
45. Начало боли (внезапное/постепенное) – Onset of pain (sudden/gradual)
46. Episode/attack of pain, occurrence of pain – приступ боли
47. To induce/cause pain, to bring pain on – вызывать боль
48. To locate in, to settle in, to be limited to (of pain) – локализоваться (о боли)
49. To suffer fro pain – мучиться о боли
50. To increase/to worsen/to precipitate – усиливаться (о боли)
51. To subside / to remit – стихать, уменьшаться (о боли)

 

1. What usually causes the pain? – Что обычно вызывает боль?
2. After what does the pain occur? – После чего возникает боль?
3. What kind of pain do you have? – Какая у Вас боль?
4. Where does the pain radiate to? To which side, flank, upwards, downwards, into the arm (leg, shoulder) - Куда отдает боль? В какую сторону, в какой бок, вверх, вниз, в руку (ногу, плечо)?
5. Is this the first occurrence of pain? – Это первый приступ боли?
6. Has the pain gone (Does the pain persist? Has the pain become more/less intense, worsened, decreased?) – Боль прошла (не проходит, стала меньше/больше, усилилась, уменьшилась)?
7. What do you attribute these pains to? – C чем Вы связываете эти боли?
8. Will you show me where it hurts now? In what body position do you feel pain the most? Покажите, где Вы чувствуете боль сейчас. В каком положении Вы чувствуете боль сильнее?
9. Was the onset of the pain sudden (gradual)? – Боли начались внезапно, постепенно?
10. What is the pain relieved by? By rest, drugs, particular food, fasting? - Чем облегчается боль? Покоем, лекарствами, особой пищей, голоданием?
11. Is it painful? Does it hurt? - Больно? Болит?
12. I believe you have ….. – Полагаю, что у Вас ….

 

1. Translate from Russian into English