Appendicitis


Overview

Appendicitis is inflammation of the appendix. The appendix is a small pouch attached to the beginning of your large intestine.

Symptoms

The symptoms of appendicitis vary. It can be hard to diagnose appendicitis in young children, the elderly, and women of childbearing age.

Typically, the first symptoms are:

  • Pain around your belly button (it may be vague at first, but becomes increasingly sharp and severe)
  • Reduced appetite
  • Nausea
  • Vomiting
  • Low-grade fever

As the inflammation in the appendix increases, the pain tends to move into your right lower abdomen and focuses directly above the appendix at a place called McBurney's point. If your appendix ruptures, the pain may lessen briefly and you may feel better. However, once the lining of your abdominal cavity becomes inflamed and infected (a condition called peritonitis), the pain gets worse and you become sicker. Your abdominal pain may be worse when walking or coughing. You may prefer to lie still because sudden movement causes pain.

Later symptoms include:

  • Chills
  • Constipation
  • Diarrhea
  • Fever
  • Loss of appetite
  • Nausea
  • Shaking
  • Vomiting

Treatment

If you have an uncomplicated case, a surgeon will usually remove your appendix soon after your doctor thinks you might have the condition. For information on this type of surgery see: appendectomy.

If a CT scan shows that you have an abscess from a ruptured appendix, you may be treated for infection and have your appendix removed after the infection and inflammation have gone away.

Causes

Appendicitis is one of the most common causes of emergency abdominal surgery in the United States. It usually occurs when the appendix becomes blocked by feces, a foreign object, or rarely, a tumor.

Tests & diagnosis

If you have appendicitis, your pain will increase when the doctor suddenly releases the pressure after gently pressing on your lower right belly area. If you have peritonitis, touching the belly area may cause a spasm of the muscles. A rectal examination may reveal tenderness on the right side of your rectum.

Doctors can usually diagnose appendicitis by your description of the symptoms, the physical exam, and laboratory tests. In some cases, additional tests may be needed. These may include:

  • Abdominal CT scan
  • Abdominal ultrasound (sonogram)

Prognosis

If your appendix is removed before it ruptures, you will likely get well very soon after surgery. If your appendix ruptures before surgery, you will probably recover more slowly, and are more likely to develop an abscess or other complications.

Complications

  • Abnormal connections between abdominal organs or between these organs and the skin surface (fistula)
  • Abscess
  • Infection of the surgical wound
  • Peritonitis

When to contact a doctor

Call 911 or go to the nearest emergency room if:

  • Your pain is severe, sudden, or sharp
  • You have a fever along with your pain
  • You are vomiting blood or have bloody diarrhea
  • You have a rigid, hard abdomen that is tender to touch
  • You are unable to pass stool, especially if you are also vomiting
  • You have chest, neck, or shoulder pain
  • You are dizzy or light-headed

Call your health care provider if you develop abdominal pain in the lower-right portion of your belly, or any other symptoms of appendicitis. Also call your doctor if:

  • You have nausea and lack of appetite
  • You are unintentionally losing weight
  • You have yellowing of your eyes or skin
  • You have bloating for more than 2 days
  • You have had abdominal discomfort for more than 1 week
  • You have burning with urination or you are urinating more often than usual
  • Your pain gets worse when you take antacids or eat something


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