Appendicitis

Reviewed By:   Anil Ghimire, MD

Appendicitis is the inflammation of the appendix. Appendix is a small, finger-shaped tubular structure attached to the large intestine located at the right side of lower abdomen. There is no known function of appendix in human body. When infected with bacteria or due to the blockage, the appendix gradually swells and gets filled with pus. If not treated on time the appendix may rupture spreading the infectious material into the abdomen and even in the blood. Hence, a patient with appendicitis needs to get emergency care before it ruptures.

Anybody can develop appendicitis but it occurs more commonly between the ages of 10 to 30 and is more common in males than females.

 

Causes

The cause of inflammation in appendix may not be known in many cases. However, in some case, it is thought to be caused by a blockage of the lumen of appendix by the hard stool and indigestible food particles. Once the blockage causes pooling of secretion, bacteria invade the appendix and start inflammation and swelling.

 

Symptoms

Appendicitis presents with abdominal pain. The pain initially starts around navel and gets localised to the right side of the lower abdomen. The pain becomes severe while coughing or during sudden movements and relieved by knee flexion to the chest while. Other symptoms of appendicitis are:

  • Nausea or vomiting
  • Swelling in the abdomen
  • Fever
  • Inability to pass gas
  • Constipation or diarrhea
  • Frequent passing of urine

 

If the appendix has ruptured, the symptoms become even worse:

  • Severe pain that spreads to the whole abdomen
  • Pain increases with slight movement; moving your knees towards chest also does not work.
  • Pain may be felt around the back, groin
  • If you are pregnant, the pain may be vaguely felt up the abdomen as the appendix is moved up by the baby

 

Diagnosis

If you have the above mentioned symptoms, you should immediately seek medical help. The doctor will diagnose the condition if you have the typical signs and symptoms. Sometimes other tests are needed.

  • Blood tests: to check for signs of infection
  • Urinalysis: to rule out urinary tract infection
  • Ultrasound or CT scan may also help in diagnosis

 

Treatment

Surgical removal of the inflamed appendix is the treatment of choice. If the appendix has ruptured, you will be taken to the operation theatre immediately. If there is no rupture, occasionally you will be monitored and given antibiotics but most of the time surgery is performed to avoid the rupture. People with appendix surgery normally recover completely and can go home after two to three days. The surgery can be done laparoscopically and has quicker recovery than conventional open surgery. Antibiotics are prescribed after the surgery. If the appendix has ruptured antibiotics are given for longer period.

 

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