Appendicitis

The appendix is a finger-shaped tube 3½-inches long extending from the right side of the large intestine. The exact function of this organ is not clear. Appendicitis is a condition in which the appendix becomes inflamed and filled with pus. It is a medical emergency requiring immediate surgical removal of the appendix. If left untreated, there are chances the appendix will burst spreading the infectious material into the abdominal cavity (peritoneum). This can inflame the abdominal cavity; a condition called peritonitis, and can sometimes be fatal if not treated urgently. Appendicitis can strike at any age, but is more common between the ages of 10 and 30 years.

Causes

The causes of appendicitis can include:

  • Obstruction of the appendix cavity by a fecal stone (hard piece of stool), food wastes, or tumor.
  • Gastrointestinal infections
  • Inflammations

Any of these conditions cause the bacteria naturally present in the appendix to rapidly multiply, leading to inflammation and infection.

Signs and Symptoms

The signs and symptoms of appendicitis include:

  • Mild pain in the upper abdomen and belly button region which increases to a sharp pain as it moves into the lower right abdomen
  • Rebound tenderness:  when pressure is applied to the painful area and then released, the pain increases.
  • Pain with coughing or walking
  • Abdominal swelling and cramps
  • Loss of appetite
  • Nausea and vomiting
  • Bloating
  • Low-grade fever
  • Painful urination
  • Constipation or diarrhea

Diagnosis

It is difficult to diagnose appendicitis as the symptoms are similar to other health problems.

Your doctor will examine your symptoms and conduct a physical examination of your abdomen.

Diagnostic tests include:

  • Blood test to check for high white blood cell count
  • Urine test to exclude urinary tract infection or a kidney stone
  • Imaging tests including abdominal X-ray, ultrasound or computerized tomography (CT) scan

Treatment

Surgery is the standard treatment for appendicitis. Antibiotics are often given before surgery.

Your doctor will perform the surgery under general anesthesia. The surgical technique for removal of the inflamed appendix will depend on you and your surgeons’ preference and whether the appendix has ruptured.

The surgical techniques include:

Laparoscopic appendectomy: Appendectomy is the surgical removal of appendix, a small finger-shaped organ attached to the cecum (first part of the colon). Appendectomy is indicated in appendicitis, the inflammation of appendix and can be done two ways.

The older method, laparotomy, removes the appendix through a single incision in the lower right area of the abdomen. The newer method, laparoscopic surgery, uses several smaller incisions and special surgical tools fed through the incisions to remove the appendix.

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Open appendectomy: Your surgeon will perform open surgery through an incision of 2 to 4 inches on the abdomen and remove the appendix. If a rupture has occurred, the peritoneal cavity will be thoroughly irrigated to remove any pus.

Intra-abdominal abscess is a complication that can occur post-operatively with appendicitis. Fortunately, the treatment is usually percutaneous drainage with a small tube by interventional radiology.

Summary

Appendicitis is a condition where the appendix becomes inflamed and infected requiring immediate surgical removal. You should consult your doctor if you experience symptoms of appendicitis in order to prevent life threating conditions caused due to a ruptured appendix.