What does appendix pain feel like? - David R. Flum

Translator: Hoi Ieng Chao Reviewer: Thomas Tam

In April 1961, the Sixth Soviet Antarctic Expedition took a harrowing turn.

1961 年 4 月，蘇聯第六次南極探險 發生咗一個悲慘嘅轉折。

Doctor Leonid Rogozov, the team’s only physician,

團隊唯一嘅醫生 Leonid Rogozov，

began feeling weak and feverish,

開始覺得身體虛弱同發燒，

with an excruciating pain in his right side.

佢右邊極之痛。

After a few days, it became clear that he had appendicitis,

過咗幾日，佢明顯有闌尾炎，

an infection that can cause the appendix to burst.

一種令到闌尾爆裂嘅感染。

And Rogozov knew that if his appendix did rupture,

而 Rogozov 知道， 如果佢嘅闌尾真係破裂，

it would likely kill him.

好可能會殺死佢。

Outside a blizzard raged,

外面一場暴雪肆虐，

令到佢離開車站好危險，

making it dangerous for him to leave the station,

or to have anyone else travel in.

或者畀其他人嚟搵佢。

So Rogozov faced a gut-wrenching choice: wait for help that may never come,

Rogozov 揀咗個 令人心痛嘅選擇：

等待可能永遠唔會嚟嘅幫助，

or cut open his own abdomen and remove the appendix himself.

或者係割開自己個肚， 移除自己嘅闌尾。

While Rogozov’s predicament may have been extreme,

雖然 Rogozov 嘅困境 可能係極端嘅，

但闌尾炎好普通。

appendicitis is not uncommon.

大約每 12 個人 就有 1 個人會受到影響。

It affects roughly 1 in 12 people.

So, what causes appendicitis?

噉，係咩原因引起闌尾炎呢？

And why is this organ so prone to bursting?

同埋點解呢個器官 咁容易發病？

The appendix is a small, worm-shaped pouch attached to the large intestine

闌尾係一個附喺大腸嘅蟲形小袋，

that houses a diversity of gut microbes.

嗰度有多種腸道微生物。

Scientists long speculated that it was a useless artifact of evolution.

科學家好耐以嚟都推測 呢個係進化嘅無用神器。

Recent evidence shows that this organ independently evolved

最近嘅證據顯示 呢個器官係獨立進化嘅，

in many different mammals.

喺好多唔同嘅哺乳動物身上。

This suggests that it probably has some function,

呢個表明佢可能有啲功能，

though it's likely subtle.

雖然好可能係微妙嘅。

One possibility is that the appendix serves as a reservoir

一個可能性係闌尾 用作儲存庫

畀健康嘅腸道細菌，

for healthy gut bacteria,

或者佢可能會喺增強 免疫反應方面發揮作用。

or it may play a role in mounting immune responses.

What we do know is this puzzling organ can cause serious complications.

我哋知道嘅係，呢個令人費解嘅器官 會引起嚴重嘅併發症。

Most cases of appendicitis start with some sort of obstruction.

大部分嘅闌尾炎病例 都係由某啲阻塞開始。

For example, a small, dried piece of stool,

例如，一塊細嘅， 乾咗嘅大便，

called an appendicolith,

叫做闌尾石，

can lodge itself in the organ’s entrance.

可以喺器官嘅入口度停留。

Other times, pathogens like viruses or parasites activate the immune system,

某啲時候，病原體例如病毒 或者寄生蟲會激活免疫系統，

causing inflammation.

引起炎症。

This immune response may even be triggered

呢個免疫反應甚至會被觸發

by one of hundreds of species of bacteria

由幾百種細菌之一

that normally reside in your gut.

通常喺你腸道入面嘅嘢。

As a result, nearby lymph nodes swell,

結果，附近嘅淋巴結腫脹，

effectively closing off the appendix’s opening.

有效關閉咗闌尾嘅開口。

Because the appendix is a closed loop, when it's sealed, pressure builds quickly.

因為佢係一個閉環， 當佢封咗之後壓力就好快增加。

This creates the perfect environment for bacteria to colonize and overgrow.

噉樣就可以創造出完美嘅環境 令細菌繁殖同過度生長。

As the inflamed appendix bloats, discomfort sets in.

當發炎嘅闌尾腫脹， 就會出現唔舒服嘅感覺，

And this pain is different from your everyday stomach ache.

而呢種痛同你日常嘅肚痛唔同。

It typically starts near the belly button

佢通常由肚臍附近開始，

and then migrates to the lower right abdomen and intensifies.

然後轉移到右下腹部並且加劇。

If left untreated, the appendix can continue to stretch,

如果唔醫， 闌尾可以繼續伸展，

hindering blood flow and weakening the organ walls.

阻礙血液流動 同埋削弱器官牆壁。

Eventually, this can cause the appendix to rupture,

最終，呢個會導致 闌尾破裂，

allowing the infection to spread within the abdomen,

令到感染喺腹部內擴散，

where it can pose fatal consequences.

喺呢度可能會帶嚟致命嘅後果。

Thankfully, not all cases of appendicitis will lead to a rupture,

好彩，唔係所有 闌尾炎個案會導致破裂，

but it's impossible to know exactly when or if

但係冇可能知道 究竟幾時

或者如果單單係症狀 就會令到個闌尾爆裂。

the appendix will burst from symptoms alone.

So, it’s recommended that all people with severe abdominal pain

所以，建議所有 有嚴重腹痛嘅人

seek immediate medical attention.

立即尋求醫療協助。

Since doctors first identified appendicitis in the late 1800s,

自從醫生喺 19 世紀末 首次發現闌尾炎之後，

an appendectomy, or the surgical removal of the appendix,

闌尾切除術， 或者手術切除闌尾，

has been the standard treatment.

已經係標準治療。

It’s normally performed quickly, within 24 hours of diagnosis.

通常會喺診斷後 24 小時內快速完成。

Doctors remove the inflamed organ, which can double in size,

醫生會移除發炎嘅器官， 佢可以增大一倍，

either through one large incision,

可透過一個大切口，

or through several smaller incisions using a camera and small instruments.

或者用相機同小型儀器做幾個較小嘅切口。

Recovery is typically quick,

復原通常好快，

and most patients are discharged within a day or two.

同埋大部分病人 都會喺一兩日出院。

Though, if the appendix has burst, surgery can be more extensive

雖然，如果闌尾已經爆咗， 手術可以更複雜，

as any bacteria and pus need to be thoroughly cleaned

因為都需要徹底清潔 喺腹腔入面，

from the abdominal cavity.

任何細菌同膿。

In the long term, living without an appendix

長遠嚟講， 冇闌尾嘅生活

is unlikely to lead to any health issues.

唔太可能導致任何健康問題。

Today, thanks to medical advances, many patients avoid surgery altogether.

今日，多謝醫學嘅進步， 好多病人完全避免做手術。

Doctors have learned that appendicitis can often be treated

醫生都知道係闌尾炎 通常可以治療，

with a simple course of antibiotics,

用一個簡單嘅抗生素療程，

started in the emergency room and continued at home.

喺急症室開始 然後喺屋企繼續。

無論選擇咩治療方法，

No matter the chosen course of treatment,

it’s likely to be less distressing than Rogozov’s,

呢個可能比 Rogozov 嘅痛苦少啲，

who, after giving himself local anesthesia,

佢畀咗自己 局部麻醉之後，

removed his own appendix, stitched himself up,

移除咗自己嘅闌尾， 又自己縫合，

and resumed his regular duties just two weeks later.

同埋只係需要兩個星期 恢復咗佢嘅正常職責。

Nevertheless, thanks to his story,

不過，多謝佢嘅故事，

doctors on remote stations in Antarctica now know to bring plenty of antibiotics

南極偏遠車站嘅醫生 而家知道要帶好多抗生素

to treat appendicitis,

治療闌尾炎，

just in case.

以防萬一。