As a general surgeon participating in the on call rota at Tunbridge Wells Hospital, I provide general acute surgical care for a wide range of conditions. Approximately 70% of emergency admissions relate to the abdomen, with the other admissions made up of a range of problems from other areas. Some of the commonest conditions I treat include appendicitis, skin abscesses and acute abdominal pain, the latter of which includes a large number of different pathologies. Please see the attached link for more information about these conditions.
SKIN ABSCESSES
Abscesses are contained collections of infection. The commonest sites for skin abscesses in my practice are infected skin cysts or hair follicles, pilonidal abscesses (usually in the skin of the lower back between the buttocks) and around the back passage (peri-anal abscesses) Each is caused by different disease processes but all are treated initially along similar principles:
1) Treat the infection – this may involve antibiotics but if this hasn’t worked or the abscess is too large then this will involve an opera- tion to open the abscess cavity and leave it open to drain
2) Treat the underlying cause if needed – often draining the abscess is sufficient to get rid of the underlying cause but sometimes further treatment is needed once the abscess cavity has healed.
APPENDICITIS
This is a common condition affecting people of all ages, but despite being sometimes regarded as a problem in childhood, it is most common in adults in their 20s and 30s. The appendix is a blind-ending tube which comes off the right side of the large bowel near to where this joins to the small bowel. It has no known function and there are no convincing theories as to why it is there in the first place. It most commonly becomes blocked by a small pellet of stool which then leads to infection and inflammation.
What symptoms would I get?
There are three common symptoms which, if all are present are strongly suggestive of appendicitis:
1) Abdominal pain which starts as a generalised ache and gradually moves over to the right side of the abdomen to rest over the appendix and becomes sharper
2) Gastrointestinal upset such as vomiting or diarrhoea
3) Loss of appetite (present in 70% of people with appendicitis)
People admitted with suspected appendicitis will usually have some blood tests which often show a rise in the inflammatory markers
and numbers of white blood cells (the blood cells which fight infection).
What treatment will I need?
Some cases of appendicitis may settle with antibiotics alone, however the an operation to remove the appendix is still the recommended