Appendicitis | Johns Hopkins Medicine

What is appendicitis?

The appendix is a thin tube that is joined to the large intestine. It sits in the lower right part of your belly (abdomen). When you are a young child, your appendix is a working part of your immune system, which helps your body to fight disease. When you are older, your appendix stops doing this and other parts of your body keep helping to fight infection.

The appendix can get infected. If not treated it can burst (rupture). This can happen as soon as 48 to 72 hours after you have symptoms. Because of this, appendicitis is a medical emergency. If you have symptoms, see a doctor right away to avoid more infection, which can be life-threatening.

What causes appendicitis?

Appendicitis happens when the inside of your appendix is blocked. Appendicitis may be caused by various infections such as virus, bacteria, or parasites, in your digestive tract. Or it may happen when the tube that joins your large intestine and appendix is blocked or trapped by stool. Sometimes tumors can cause appendicitis.

The appendix then becomes sore and swollen. The blood supply to the appendix stops as the swelling and soreness get worse. Without enough blood flow, the appendix starts to die. The appendix can burst or develop holes or tears in its walls, which allow stool, mucus, and infection to leak through and get inside the belly. The result can be peritonitis, a serious infection.

Who is at risk for appendicitis?

Appendicitis affects 1 in 1,000 people living in the U.S. Most cases of appendicitis happen to people between the ages of 10 and 30 years. Having a family history of appendicitis may raise your risk, especially if you are a man. For a child, having cystic fibrosis also seems to raise the risk of getting appendicitis.

What are the symptoms of appendicitis?

The following are common symptoms of appendicitis. Your own symptoms may vary.

Pain in the abdomen is the most common symptom. This pain:

• May start in the area around your belly button and move to the lower right-hand side of your belly. It may also start in the lower right-hand side of your belly.
• Often gets worse as time goes on.
• May feel worse when you are moving, taking deep breaths, being touched, and coughing or sneezing.
• May be felt all over your belly if your appendix bursts.

Other common symptoms include:

• Upset stomach and vomiting
• Loss of appetite
• Fever and chills
• Trouble having a bowel movement (constipation)
• Loose stool (diarrhea)
• Trouble passing gas
• Swollen belly

Do not take pain medicines. They may hide other symptoms your healthcare provider needs to know about.

Appendicitis symptoms may look like other health problems. Always see your healthcare provider to be sure.

How is appendicitis diagnosed?

Your healthcare provider will ask about your past health and do a physical exam. He or she may also have you take the following tests:

• Blood tests: To check for signs of infection, such as having a high white blood cell count.
• Urine tests: To see if you have a urinary tract infection.

You may also have some imaging tests, including:

• Abdominal ultrasound: Lets the doctor see internal organs as they work and checks how blood is flowing through different blood vessels.
• CT scan: Shows detailed images of any part of the body, such as the bones, muscles, fat, and organs.
• MRI: Sometimes used to diagnose appendicitis, especially in a pregnant woman, instead of CT scan.

How is appendicitis treated?

Appendicitis is a medical emergency. It is likely the appendix will burst and cause a serious, deadly infection. For this reason, in almost all situations, your healthcare provider will advise that you have surgery to remove your appendix.

The appendix may be removed in an open procedure or using laparoscopy:

• Open (traditional) surgery method. You are given anesthesia. A cut (incision) is made in the lower right-hand side of your belly. The surgeon finds the appendix and takes it out. If the appendix has burst, a small tube (shunt) may be placed to drain out pus and other fluids in the belly. The shunt will be taken out in a few days, when your surgeon feels the infection has gone away.
• Laparoscopic method. You are given anesthesia. This surgery uses several small cuts (incisions) and a camera (laparoscope) to look inside your belly. The surgical tools are placed through a few small incisions. The laparoscope is placed through another incision. A laparoscopy can often be done even if the appendix has burst.

If your appendix has not burst then your recovery from an appendectomy will only take a few days. If your appendix has burst, your recovery time will be longer and you will  need antibiotic medicine.

You can live a normal life without your appendix. Changes in diet or exercise are usually not needed.

Complications of Appendicitis

The main problem with appendicitis is the risk of a burst appendix. This may happen if the appendix is not removed quickly. A burst appendix can lead to infection in the belly, called peritonitis. Peritonitis can be very serious and even cause death if not treated right away.

Can appendicitis be prevented?

At this time, there is no known way to stop appendicitis from happening.

When should I call my healthcare provider?

If you have any of the symptoms of appendicitis listed above, call your healthcare provider right away. Or go to an emergency department. Appendicitis is a serious medical emergency. It should be treated as quickly as possible.

Key Points About Appendicitis

Appendicitis is when your appendix becomes sore, swollen, and diseased.

• It is a medical emergency. You must seek care right away.
• It happens when the inside of your appendix gets filled with something that causes it to swell, such as mucus, stool, or parasites.
• Most cases of appendicitis happen between the ages of 10 and 30 years.
• It causes pain in the belly, but each person may have different symptoms.
• Your health care provider will advise that you have surgery to remove your appendix.
• You can live a normal life without your appendix.

Next Steps

Tips to help you get the most from a visit to your healthcare provider:

• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.

What Can Happen If Your Appendix Bursts?

Appendicitis: Understanding a Common Condition and its Life-Threatening Risks

Introduction:

If you have ever heard someone say they have had appendicitis, you may think of it as a common ailment. However, appendicitis is a serious condition that, if left untreated, can lead to life-threatening complications. This blog will discuss appendicitis, its symptoms, and the importance of prompt medical attention. We will also explore the risks of untreated appendicitis, including what can happen if your appendix bursts.

What is appendicitis?

The appendix is a thin, pouch-like tube that lies near the meeting point of the small and large intestines. Appendicitis is a common condition that involves inflammation and/or infection of the appendix. The precise cause of appendicitis is not well understood, and it can affect anyone at any time, although it is more frequently seen in children. Because appendicitis can lead to widespread infection, a ruptured appendix, and other severe or life-threatening complications, almost immediate diagnosis and treatment are necessary.

Symptoms of appendicitis:

The signs and symptoms of appendicitis can mimic those of other conditions, making it a difficult ailment to self-diagnose. Some of the most common symptoms include:

• Sudden onset of abdominal pain
• Abdominal pain that migrates and settles in the lower right side
• Fever
• Chills
• Fatigue
• Loss of appetite
• Nausea and vomiting
• Abdominal bloating or swelling
• Pain with physical activity

What happens when your appendix bursts?

When appendicitis is left untreated, bacteria and pus begin to build up in the appendix and cause it to swell. Ultimately, the wall of the appendix is compromised, allowing the pus and other bacteria to ooze out into the abdominal cavity. Though it is not an explosive event, this is referred to as bursting or rupturing of the appendix. As the infection spreads throughout the abdomen, patients often experience worsening symptoms, including high fever and severe pain.

Most cases of a ruptured appendix occur about 48 – 72 hours after the onset of symptoms. A ruptured appendix is always considered an emergency and requires immediate treatment. If left untreated, a ruptured appendix can lead to widespread infection, abscess, sepsis (an infection in the bloodstream), and even death.

Why seek immediate medical attention?

To ensure your health and safety, signs and symptoms of appendicitis should be evaluated immediately by a medical professional. The award-winning team of board-certified emergency room physicians at iCare ER & Urgent Care is highly experienced in the early detection and treatment of appendicitis in Frisco and Fort Worth, TX. During your visit, you will be evaluated promptly and may undergo lab work, imaging studies, and other tests to determine with certainty whether your symptoms are related to appendicitis.

Conclusion:

Appendicitis is a serious condition that requires immediate medical attention. If you suspect that you or someone you know has appendicitis, seek prompt medical attention to prevent life-threatening complications.  At iCare ER & Urgent Care in Frisco or Fort Worth, TX we are committed to providing almost immediate appendicitis treatment in Frisco and Fort Worth, TX. Our expert team of board-certified ER physicians and medical professionals is available 24/7 to evaluate and treat all of your emergency medical needs.

Why appendicitis is dangerous and how to deal with it

Removal of the appendix still ranks first among emergency surgical operations. How to recognize appendicitis and why it is important to see a doctor as soon as possible, says Gazeta.Ru.

In the right iliac region of a person there is an appendix – a worm-like appendage of the caecum up to 1 cm thick and up to 23 cm long (usually 7-9 cm). It performs a protective function of the body due to the accumulation of lymphoid tissue in it. In addition, it plays an important role in maintaining the intestinal microflora.

Inflammation of this process is called appendicitis. Until now, the most common method of treating appendicitis is the removal of the appendix, but in recent decades, the prevalence of antibiotic therapy has gradually increased.

One of the first known operations to remove the appendix was performed in 1735 in London by the royal surgeon Clodis Amiand. He operated on an 11-year-old child who soon recovered. By 1839the clinical picture of acute appendicitis was described in detail, it was also found that it is an independent disease, and not a complication of inflammation of the caecum, as previously thought.

The term “appendicitis” appeared in 1886, it was introduced by the American physiologist Reginald Gerber Fitz. Then it was found that the optimal method of treatment is the removal of the appendix. In Russia, the first operation to remove the appendix was performed in 1890. However, they began to be held regularly only after the IX Congress of Russian Surgeons in 1909 – before that, doctors adhered to expectant tactics, resorting to surgical intervention only in extreme cases.

The first doctor to operate on himself was the American surgeon Evan Kane in 1921. He successfully removed his own appendix as part of a study of patient tolerance to local anesthesia.

And in 1961, the Soviet surgeon Leonid Rogozov, a member of the 6th Soviet Antarctic Expedition, operated independently.

During the expedition, he discovered a clinical picture of acute appendicitis, conservative treatment – rest, hunger, local cold and antibiotics – did not help. There was no way to get to the hospital.

With the help of other members of the expedition, who provided instruments and monitored Rogozov’s condition, the surgeon operated on himself for almost two hours. Because of the weakness that appeared during the operation, he now and then had to pause. But he successfully completed the operation, and a week later he removed the stitches.

“At the most difficult stage of the appendix removal, I lost heart: my heart stopped and noticeably slowed down, and my hands became like rubber,” Rogozov recalled. Well, I thought, this will end badly. But all that remained was to actually remove the appendix! But then I realized that I was actually already saved!”

Appendicitis manifests itself at any age, but mostly at 15-35 years of age. Women experience it 2-3 times more often than men, but men are more likely to experience complications. The removal of the appendix accounts for up to 80% of all emergency operations. The incidence of acute appendicitis is 4-5 cases per 1000 people per year.

The main symptoms of appendicitis are pain in the right side, fever, nausea and vomiting. On palpation of the right iliac region, appendicitis is characterized by increased pain with a sharp decrease in pressure.

In clinical practice, there are two forms of appendicitis – acute and chronic. In the event of acute appendicitis, urgent treatment is necessary, the main cause of death is a delay of more than two days between the onset of symptoms and the start of treatment.

The delay threatens with the development of complications, for example, the formation of appendicular infiltrate – accumulation of altered tissues tightly soldered together. In this case, it is no longer possible to remove the appendix – it turns out to be inseparable from the tissues surrounding it. The infiltrate can resolve on its own, which most often happens, or lead to suppuration with the formation of an abscess.

Another common complication is diffuse purulent peritonitis, inflammation of the peritoneum, complicated by the appearance of purulent foci.

Peritonitis directly threatens the patient’s life and in this case, an early operation is simply necessary.

Chronic appendicitis is rare. It occurs after acute appendicitis and is characterized by atrophic changes in the tissues of the appendix.

There are many theories for the development of acute appendicitis. According to the mechanical theory, it occurs due to blockage of the lumen of the appendix, mainly by fecal stones. When the lumen is filled with mucous secretion, the diameter of the process increases several times. This compresses the vessels within the appendix itself, leading to acute inflammation and necrosis.

Another cause of inflammation of the appendix can be an infection – the causative agents of infectious diseases, penetrating into the mucous membrane of the organ, lead to the development of appendicitis. It is also assumed that appendicitis may occur due to vascular spasms and circulatory disorders in the intestinal tissues.

At risk are people who regularly suffer from constipation. It is also suggested that the incidence of acute appendicitis is associated with a low content of plant fiber in the diet.

As research has emerged over the past 20 years showing that appendicitis can be successfully treated with antibiotics, the number of surgeries performed in the US has halved.

However, analysis of almost half a million registered cases of appendicitis showed that those patients who were operated on the first or second day after going to the hospital died from possible complications 2.4 times less than those who were treated with non-surgical methods.

As it turned out, older people were more likely to undergo conservative treatment, which further worried the researchers.

“Surgeons in the US choose older patients for non-surgical treatment because they may not be the best candidates for surgery,” said study lead author Dr. Isaiah Turnbull. —

However, these patients are at increased risk of poor outcomes because if treatment fails, their body does not have the resources to fight the disease.”

However, the treatment of appendicitis with antibiotics is not bad is suitable for children. An analysis of 404 cases of acute appendicitis in childhood showed that with an uncomplicated course of the disease, treatment with antibiotics is successful in 90% of cases. However, if appendicitis occurs (exit of a stone from the appendix into the abdominal cavity) or other complications, it is still recommended to resort to surgical treatment.

Is it possible to die from appendicitis: death from appendicitis

Contents

• Characteristics of the disease
• Patient’s mistakes
• Determine the attack of appendicitis
• Diagnosis of pediatric appendicitis
• How to help the sick
• Useful video

Appendicitis is considered one of the most dangerous diseases that must be treated immediately.

Is it possible to die from appendicitis? Naturally. It is important to know when the patient needs help immediately.

The information in this article will help reduce your risk of death.

Characteristics of the disease

Every person has a vermiform appendix in the stomach. Appendicitis is called its inflammation.

This process is located in the area of ​​the caecum. Its swelling is the cause of severe pain in the lower abdomen.

It is accompanied by the following symptoms:

• Vomiting.
• Nausea.
• Severe pain.
• Loose stool.

These are the main signs of inflammation of the appendix. You can die from appendicitis, so you don’t have to count on the fact that you can wait out the attack.

To avoid death, it is necessary to seek medical help at the time of the first signs of this disease.

Otherwise, the appendix may rupture. Then a painful death awaits the patient. But don’t panic!

The main thing is to give up trying to help yourself at home. If you encounter this problem, then immediately call an ambulance.

Appendicitis plays the role of a collection of all harmful “things” in the body. In fact, it is a natural filter that is in the body of every person. An excess of harmful substances leads to its inflammation.

Rupture of the appendix will result in “harmful” contents in the stomach. This situation is fraught with the appearance of peritonitis. After the development of this pathology, the patient will die.

Speaking about whether it is possible to die from a rupture of the appendix, it is impossible not to mention that its contents can enter the bloodstream.

And this, in turn, will provoke its infection. Even if the patient does not suffer death, blood poisoning will become a problem for him, which will significantly worsen the quality of life. It can also lead to death.

However, it is a mistake to believe that death is the only consequence of appendicitis. Sometimes the disease can develop in a completely different scenario.

For example, there are cases when the human body independently suppressed the inflammatory process.

However, one must remember that the attack will recur, moreover, it will occur regularly. This will cause the development of a pathological process in the body.

Patient errors

If someone is said to have died from a ruptured appendix, they probably did not seek medical attention in a timely manner.

It is important to remember to call an ambulance at the first signs of appendicitis. Otherwise, you will not have to rely on successful relief of the attack.

One of the most common mistakes of medically illiterate people is applying a heating pad to the sore spot.

There is an opinion among the people that if heat is applied to the lesion, discomfort can be stopped.

In fact, it is impossible to heat the area of ​​appendicitis in any case. This will only aggravate the situation of the patient and worsen his well-being.

Moreover, heating this area is fraught with rupture of the appendix. The result is the development of peritonitis and death.

The second common mistake is taking painkillers. If the patient manages to stop the pain attack by taking analgesics, and also manages to stop the spasm that has arisen in the lower abdomen, this will greatly complicate the diagnosis.

If the patient does not feel pain in the abdominal area, doctors will not determine the presence of inflammation in it, therefore, an untimely diagnosis will cause an exacerbation of the disease.

The third mistake is trying to comfort yourself with bad habits. In no case should the patient drink alcohol or smoke cigarettes at the time of the attack. The fact is that such behavior will certainly aggravate the patient’s condition.

The components contained in alcoholic beverages have a negative effect on the work of digestion, therefore – they will have a negative effect on the attack.

The fourth mistake is eating at the time of a painful attack. Overeating can make things worse.

If the patient’s stomach is overloaded, then in the lower part of the abdomen he will feel severe pain, which can lead to loss of consciousness.

Based on this, the following recommendations can be made:

1. Do not apply heat to the lesion during an attack.
2. Call an ambulance in a timely manner.
3. Do not attempt to control an attack with pain medication.
4. Stop smoking and drinking alcohol.
5. Refuse to eat at the time of an attack of appendicitis.

Compliance with these simple rules will increase the chances of a successful recovery without complications.

Determining an attack of appendicitis

To understand that the moment to call an ambulance has come, you should familiarize yourself with the medical rules for determining your appendix.

First, if you feel discomfort in the lower abdomen, be sure to listen to your body. Many people feel their ailments even before the obvious manifestation of their symptoms.

What is appendix pain? It manifests itself in the form of fights. They appear and then completely disappear.

As practice shows, most often, discomfort is localized on the right side of the stomach. However, it is erroneous to believe that acute appendicitis makes itself felt only by the manifestation of this symptom.

During an attack, the patient may feel discomfort in other parts of the body. For example, in the left side of the abdominal area, arm or lower back.

Secondly, in order to accurately determine the presence of appendicitis, it is necessary to press on the lesion with your hand, and then release it sharply.

Press on the point between the pelvis and the navel. The presence of inflammation in the abdominal cavity will be indicated by acute pain that occurs after pressing.

To reduce the discomfort that occurs at the time of an attack, it is recommended to lie down correctly.

If you feel pain in your abdomen while lying on your right side, try pulling your knees up to your stomach. If the pain gets worse, you probably have appendicitis.

One of the most common mistakes in the “folk” diagnosis of the appendix is ​​the formulation of an incorrect conclusion about the stage of the disease. For example, inflammation of the appendix is ​​often confused with banal poisoning.

Doctors advise you to listen to the state of your body. Acute pain in the abdominal region with stomach poisoning is a rarity.

If this symptom is accompanied by nausea, vomiting, and loose stools, the person probably has a worsening of appendicitis.

Diagnosis of childhood appendicitis

Establishing the presence of abdominal inflammation in a child requires a special responsibility of his parents.

To prevent rupture of the appendix in the stomach of a small patient, his parents should pay special attention to his condition.

First, you can not ignore the baby’s complaints about feeling unwell. If he clings to his tummy and cries, this is a clear sign of an inflammatory process in the abdominal cavity.

Of course, this behavior of the child does not always indicate appendicitis. For example, inflammation of the stomach is also diagnosed with gastritis.

However, the appendix is ​​characterized by the manifestation of such a symptom as acute cramping pain.

In children, the disease progresses much faster than in adults. Therefore, they are much more likely to die.

However, as medical practice shows, if you seek medical help in a timely manner, then the complications of pathology can be avoided.

For an adult patient, the operation to remove the affected appendix is ​​done within 10-12 hours, while for children it takes 2 times less time.

As for the symptoms of the child form of this disease, it is no different from the symptoms in an adult patient. Parents of the baby should pay special attention to his health if she complains of pain in the tummy.

It is important to remember not to self-medicate! “Home” therapy can be fatal.