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Is It Gas or Appendicitis?

When to Go to the Emergency Room from Loyola Trauma Expert

MAYWOOD, Ill .– Julie Piniuta, 21, works part time at a popular ice cream parlor in her neighborhood and often lugs several 30-lb. tubs of ice cream around.  So when she complained of a pain in her abdomen, her father Steve suspected hernia. Just 24 hours later, Julie was home from Loyola University Health System’s Acute Surgery Clinic within the Emergency Department with her appendix removed and her bikini body intact.

“I went out with my friends after work but despite being hungry, I couldn’t eat my dinner. I felt so nauseous,” said the elementary education junior at Loyola University Chicago. “Later at home, I told my parents and they suggested I sleep on it. But it hurt when I moved in my sleep, it hurt when I walked down the stairs in the morning and the pain kept getting worse.”  The Palos Hills residents went to the Loyola Emergency Department.

Pain growing in intensity is one of the key signs of appendicitis, said John Santaniello, MD, the trauma surgeon at Loyola who cared for Julie. “Indigestion, heartburn and other abdominal pain will usually decrease over time, but with the appendix it will not only get worse but it will localize in the lower right side,” he said.

The appendix is a tubelike organ on the right side of the body, connected to the bowels, that has no real function except to eliminate self-generated mucus and stool.

“When the appendix becomes blocked, usually with stray fecal matter, the secreted mucus and matter have nowhere to go and cause the appendix to swell, cutting off its blood supply,” said Santaniello, who regularly performs appendectomies. “The pressure builds up, the appendix becomes gangrenous and it ruptures if not treated in time.” Appendicitis occurs most often in those ages 10-25 and then later in life, in those ages 60 and older.

After an exam and CT scan, Julie’s appendicitis was diagnosed and her appendix removed before it burst.

“Loyola is a Level 1 trauma center, which means we have Acute Care surgeons available in the hospital 24/7 to immediately provide care ranging from a fairly routine appendix removal to a complex fistula repair,” he said. Julie came to Loyola in the evening and at 1 a.m. was having surgery.

“We made three small incisions around her belly button area and removed the appendix in a minimally invasive operation. Small cuts mean less bleeding, faster healing and less chance of infection,” Santaniello said. Julie went home that same day.

And one week later, she was on campus toting her book-filled backpack and attending class. “My teachers and classmates couldn’t believe that I was able to come back so soon after surgery,” said Julie, who is 5 foot 2 and a slight 110 pounds.

She had one follow-up visit with Santaniello three weeks after the surgery. “I was already healed and dreaming of spring break and wearing my bikini,” Julie said.

Loyola University Health System (LUHS) is a member of Trinity Health. Based in the western suburbs of Chicago, LUHS is a quaternary care system with a 61-acre main medical center campus, the 36-acre Gottlieb Memorial Hospital campus and more than 30 primary and specialty care facilities in Cook, Will and DuPage counties. The medical center campus is conveniently located in Maywood, 13 miles west of the Chicago Loop and 8 miles east of Oak Brook, Ill. The heart of the medical center campus is a 559-licensed-bed hospital that houses a Level 1 Trauma Center, a Burn Center and the Ronald McDonald® Children's Hospital of Loyola University Medical Center. Also on campus are the Cardinal Bernardin Cancer Center, Loyola Outpatient Center, Center for Heart & Vascular Medicine and Loyola Oral Health Center as well as the LUC Stritch School of Medicine, the LUC Marcella Niehoff School of Nursing and the Loyola Center for Fitness. Loyola's Gottlieb campus in Melrose Park includes the 255-licensed-bed community hospital, the Professional Office Building housing 150 private practice clinics, the Adult Day Care, the Gottlieb Center for Fitness, Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park.

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