Appendicitis

What is appendicitis?

Appendicitis is an inflammation of the appendix, a finger-shaped organ located on the lower right side of the abdomen that protrudes from the colon.

Appendicitis causes pain that generally begins at the navel and migrates to the lower right side of the abdomen. As the inflammation increases, so does the resulting abdominal pain.

Although appendicitis may occur in anyone, it most often happens in people between the ages of 10 and 30.

What causes appendicitis?

Appendicitis is broken down into two types, each with its own symptoms.

Acute Appendicitis

Accounting for the majority of appendicitis cases, acute appendicitis is generally caused by an abdominal infection that has spread to the appendix or an obstruction that has completely blocked the inner cavity of the appendix, known as the appendiceal lumen. Obstructions responsible for acute appendicitis may include:

  • Foreign object
  • Hardened stool
  • Ulcer

Chronic Appendicitis

Appendicits may be diagnosed as chronic when the appendiceal lumen is only partially obstructed due to blockages such as:

  • Enlarged lymph tissue on the appendix wall
  • Fecaliths, or calcified fecal deposits
  • Foreign objects such as stones or bullets
  • Tumors

In chronic appendicitis, the pressure from the inflammation builds but doesn’t rupture the appendix and instead results in overcoming the slight obstruction. This causes symptoms to occur and then subside over time.

Do I have appendicitis?

Symptoms of appendicitis

Symptoms of both acute and chronic appendicitis can include:

  • Constipation or diarrhea
  • Loss of appetite
  • Low-grade fever
  • Nausea
  • Sudden pain that occurs in the lower right abdomen
  • Sudden pain that originates in the navel and travels to the lower right abdomen
  • Vomiting

Diagnosing appendicitis

After taking a medical history and symptoms, your physician will perform a physical examination to assess pain by applying gentle pressure on the painful area of your abdomen, then releasing. Appendicitis pain will often feel worse after release.

Other tests include:

  • Blood test: A high white blood cell count is an indication of infection.
  • Imaging tests: Diagnostic imaging tests may be recommended such as an x-ray, ultrasound or computed tomography (CT) to aid in diagnosing or excluding appendicitis as the cause of symptoms.
  • Urine test: A urinalysis may be performed to rule out a urinary tract infection (UTI) or kidney stone.

What are the treatment options for appendicitis?

In some rare instances, appendicitis may resolve itself with a liquid diet and a round of antibiotics. In most cases, however, surgery is the only option for treating this condition, with procedures varying depending on your individual situation.

Laparoscopic surgery: A minimally invasive procedure where small incisions are made in the abdomen and small tools along with a video camera are inserted to remove the appendix. This procedure requires less downtime and promotes faster healing.

Open appendectomy: This procedure is reserved for when the appendix has ruptured and the infection has spread or an abscess has formed. It allows the surgeon to effectively clean the abdominal cavity. Alternatively, if an abscess has formed after the appendix has ruptured, it may be drained by placing a tube into the abscess. The appendectomy may then be performed after the infection is under control.

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