Acute Appendicitis

Acute appendicitis is known to occur in all age groups. Its incidence varies in different sex groups; it is more frequent in women from 20 to 40 years of age. Cases of appendicitis have been noted to occur even in infants and in very old age.

Acute appendicitis is known to begin suddenly with sharp pain which is at first felt in epigastrium but then becomes generalized in the abdomen. The pain becomes worse on deep breathing in and coughing, it does not radiate and is accompanied by nausea, retention of stools and gases.

The temperature is known or subfebrile and there is moderate leucocytosis. The ESR is initially normal. With the development of the disease temperature elevation is observed and ESR becomes increased. The pulse is quick but it is found to be not more than 90-100 beats per minute. The tongue is coated and dry.

The attack of acute appendicitis is known to last for 3-4 days. Then the temperature returns to normal, abdominal pains decrease and only a moderate tenderness is felt in the right lower part of the abdomen on palpation.

Acute appendicitis is treated surgically. The operation is performed not under general but under local anaesthesia.

The appendix is removed immediately to prevent its rupture which may result in peritonitis. Such forms of appendicitis as gangrenous and perforating are particularly dangerous to life. But sometimes even a mild form of appendicitis is likely to have a severe course and to result in perforation.

II. Переведите текст “Surgery” Part II со словарем.

Surgery

Part II

Anesthesia. The importance of good and correct anesthesia to safe surgical procedures can hardly be overestimated. Many types of anesthesia are available: general (nitrous oxide, cyclopropane, ether), intravenous, spinal, caudal, regional, and topical. The choice is usually left to that important member of the surgical team – the anesthetists. He is the one responsible for the condition of the patient during operation, while the surgeon himself and his assistants, if any, concentrate on the techniques of the surgery itself in the operative field. Because of the increasing complexity of anesthesia, the trend is toward the employment of private physician-anesthetists wherever available. (These physicians receive a separate fee for their services.) There are also skilled nurse-anesthetists. Incidentally, a patient need never fear that the surgeon will begin operating before the pain-relieving anesthetic effect has been completely achieved.

What types of surgery are there? There is practically no site in the human body which today is inaccessible to surgical operation, if indicated and warranted. Along with this has come an increasing definition of surgical specialists, so that most surgeons tend to confine themselves to operations on one region or system of the body.

Types of surgery can be described by the region of the body they deal with, in either simple or technical terms. Thus we have such terms as chest (thoracic), heart (cardiac), ear (aural), eye (ophthalmic), and bladder and kidney (genitourinary) surgery.

More comprehensive terms are:

Abdominal surgery, which treats with all the organs inside the abdomen.

Orthopedic surgery, which is concerned with diseases of the bones, joints, and muscles.

Neurosurgery, which deals with surgery on the brain and nerves distributed along the spinal cord.

Plastic surgery, which is the reconstruction of facial and other skin and soft tissues, and sometimes their transplantation from one part of the body to another, to relieve disfigurements, deformities, and malfunctions – a specialty that developed after World War I and is sometimes inadequately described as “cosmetic surgery”.

A “general surgeon” is one who tackles all kinds of surgical cases.

Surgery can also be classified by its urgency. Emergency surgery, demanded, for example, in such conditions as a fractured skull or acute bowel obstruction, brooks no delay in getting the patient to the hospital and into the operating room. Urgent surgery, as demanded by cancer or kidney stones, may be put off for a few days; required surgery, such as tonsillectomies and thyroid operations, may be postponed for a few weeks or months. There are also categories of elective surgery, such as removal of simple hemorrhoids, in which operation is strongly indicated but not imperative; and optional surgery, like “nose lifting”, which the patient may choose not to have done at all. “Office surgery”, or minor surgery, such as lancing a boil, is that which the doctor can perform without sending the patient to a hospital.

Except an emergency, the decision to undergo operation lies with the patient. The surgeon can only advise and counsel. The patient must have confidence in his advice. Sometimes a patient will want a second independent surgical opinion, and there can be no objection to such consultation.

The costs of surgery are high, although surgeons usually scale their own fees in accordance with the patient’s ability to pay. Other costs include hospital services, special drugs, special-duty nursing (if needed), blood transfusions, anesthetist’s fee, and some other possible costs. These lavish but inescapable costs have prompted the rapid development of hospital insurance and health insurance.