Mr Khokan Roy, 30 yr resident of Bhyander came in emergency with complaints of pain in abdomen & vomiting since 3 days. So far he was taking treatment from a local general practitioner, who just gave him medicines thinking it to be acidity problem. Patient tolerated pain hoping to get better with his family doctor’s medicines. but his condition slowly deteriorated in next two days as he continued to vomit & have increasing pain in abdomen. Clinical examination of this patient was sufficient to reach to the diagnosis of acute appendicitis. Subsequently his sonography confirmed that there was swelling in appendix. He was explained about the disease and prepared for emergency surgery – removal of the appendix. He was offered options of open appendectomy as well as key hole (laparoscopic) surgery. He said that he would not be able to take long leave and thus opted for Laparoscopic appendectomy. The operative findings were that the appendix had burst & lot of pus had formed around appendix. Waiting for three days had caused the appendix to burst and spread of pus. The surgery was carried out successfully – removal of the appendix along with the pus. A drainage tube was placed for couple of days to let out the inside toxins. The patient made a rapid & uneventful recovery & the wounds healed very well..
Although appendix is situated in right lower abdomen, the initial manifestation of the disease can be upper or central abdominal pain. This is called refereed pain. Often such patients are diagnosed & treated for acidity. Important time is lost and such appendix are prone to rupture and cause more trouble to patient. A proper clinical examination along with the aid of ultrasonography can prevent such disasters.
Dr. Bimal Shah is the senior most General & Laparoscopic surgeon in Mira – Bhayandar with largest series of operations. He also consults at Borivali – Dahisar. He believes in ethical practice & is available at only trust hospitals. He passed out from KEM hospital, Mumbai in 1993 and was a lecturer training newer surgeons & medical students till 1998. 
