What are the early signs of appendicitis. How is appendicitis diagnosed. What is the standard treatment for appendicitis. Can appendicitis be prevented. What complications can arise from untreated appendicitis.

Understanding Appendicitis: A Comprehensive Overview

Appendicitis is a serious medical condition characterized by inflammation of the appendix, a small pouch attached to the large intestine. This 3.5-inch-long tube of tissue, located in the lower right side of the abdomen, plays a role in producing antibodies, although its exact function remains somewhat unclear. Appendicitis is a relatively common condition, affecting approximately 1 in 20 people in the United States at some point in their lives.

While appendicitis can occur at any age, it is most prevalent among individuals between 10 and 30 years old. The condition is rare in children under two years of age. Due to its potential for severe complications, appendicitis is considered a medical emergency that typically requires prompt surgical intervention.

Identifying the Causes of Appendicitis

The primary cause of appendicitis is a blockage within the appendix. This obstruction can occur due to various factors:

• Fecal matter
• Foreign objects
• Tumors or cancerous growths
• Infections causing swelling of the appendix

When blocked, the appendix becomes inflamed and filled with bacteria, leading to the characteristic symptoms of appendicitis. Understanding these causes is crucial for early detection and treatment.

Recognizing Early Symptoms and Warning Signs

Identifying the symptoms of appendicitis early is vital for prompt treatment. The most common signs include:

• Pain in the lower right abdomen or around the navel that migrates lower
• Loss of appetite
• Nausea and vomiting following abdominal pain
• Abdominal swelling
• Fever ranging from 99-102°F (37.2-38.9°C)
• Inability to pass gas

Less common symptoms may include:

• Dull or sharp pain in various areas of the abdomen, back, or buttocks
• Painful or difficult urination
• Vomiting preceding abdominal pain
• Severe cramps
• Constipation or diarrhea with gas

If you experience any of these symptoms, it’s crucial to seek medical attention immediately. Avoid eating, drinking, or using pain relievers, antacids, laxatives, or heating pads, as these may mask symptoms or complicate diagnosis.

Diagnostic Procedures for Appendicitis

Diagnosing appendicitis can be challenging due to its symptoms resembling other conditions. Healthcare providers may employ several diagnostic tools to confirm appendicitis:

1. Physical examination of the abdomen to check for inflammation
2. Urinalysis to rule out urinary tract infections
3. Rectal examination
4. Blood tests to detect signs of infection
5. CT scans for detailed imaging of the appendix
6. Ultrasound to visualize the appendix and surrounding tissues

These tests help differentiate appendicitis from other conditions with similar symptoms, such as gallbladder problems, urinary tract infections, Crohn’s disease, gastritis, kidney stones, and ovarian issues.

Treatment Options and Surgical Procedures

Appendicitis is typically treated as a medical emergency, with surgery being the standard approach in most cases. The surgical removal of the appendix, known as an appendectomy, is performed to prevent complications such as rupture.

Appendectomy Procedure

An appendectomy can be performed through two main methods:

• Open surgery: A 4-inch incision is made in the lower right abdomen to remove the appendix.
• Laparoscopic surgery: A minimally invasive technique using a laparoscope, which requires smaller incisions and often results in faster recovery.

Before surgery, patients receive antibiotics to combat infection. General anesthesia is typically administered, ensuring the patient is unconscious during the procedure.

Alternative Treatment Approaches

Recent research suggests that treating acute appendicitis with antibiotics may be an alternative to surgery in some cases. However, this approach is not suitable for all patients and requires careful evaluation by a medical professional.

Recovery and Post-Operative Care

Recovery from an appendectomy varies depending on the surgical method used and individual factors. Generally, patients can expect:

• To be able to move around within 12 hours after surgery
• To return to normal activities within 2 to 3 weeks
• Faster recovery times for laparoscopic procedures compared to open surgery

During recovery, it’s important to monitor for potential complications. Contact your healthcare provider if you experience:

• Uncontrolled vomiting
• Increased abdominal pain
• Dizziness or fainting
• Blood in vomit or urine
• Increased pain or redness at the incision site
• Fever
• Pus from the wound

Potential Complications of Untreated Appendicitis

Untreated appendicitis can lead to severe complications, highlighting the importance of prompt medical intervention. The most serious risks include:

Appendix Rupture

A burst appendix can spill bacteria and debris into the abdominal cavity, leading to a potentially life-threatening condition called peritonitis. This serious inflammation of the abdominal cavity’s lining requires immediate treatment with powerful antibiotics and surgery to remove the infected material.

Abscess Formation

In some cases, an abscess may form outside the inflamed appendix. While this can temporarily contain the infection, the abscess may eventually rupture, leading to peritonitis. Treating an abscessed appendix often involves a two-stage process: first draining the abscess, followed by a later surgery to remove the appendix.

These complications underscore the critical nature of early diagnosis and treatment of appendicitis.

Preventive Measures and Lifestyle Considerations

While there is no surefire way to prevent appendicitis, some lifestyle factors may influence its occurrence:

• High-fiber diet: Consuming foods rich in fiber, such as fresh fruits and vegetables, may be associated with a lower incidence of appendicitis.
• Maintaining good hygiene: Proper hygiene practices may help reduce the risk of infections that could lead to appendicitis.
• Regular exercise: Physical activity can promote overall digestive health, potentially reducing the risk of appendicitis.

It’s important to note that while these measures may contribute to overall health, they do not guarantee prevention of appendicitis. Regular check-ups and prompt attention to unusual abdominal symptoms remain crucial for early detection and treatment.

Appendicitis in Special Populations

While appendicitis can affect anyone, certain groups may face unique challenges or considerations:

Appendicitis During Pregnancy

Diagnosing appendicitis in pregnant women can be challenging due to the shifting position of abdominal organs during pregnancy. Prompt diagnosis and treatment are crucial to protect both the mother and the fetus.

Appendicitis in Children

Children may have difficulty articulating their symptoms, making diagnosis more challenging. Parents and caregivers should be vigilant for signs of abdominal pain, fever, and changes in behavior that could indicate appendicitis.

Appendicitis in Older Adults

Older adults may present with atypical symptoms, potentially delaying diagnosis. They may also face higher risks during surgery, necessitating careful management and post-operative care.

Understanding these special considerations can help ensure timely and appropriate care for all individuals experiencing appendicitis.

Early Symptoms, Causes, Pain Location, Surgery, Recovery

Written by WebMD Editorial Contributors

• What Is Appendicitis?
• Where Is Your Appendix?
• What Causes Appendicitis?
• What Are the Symptoms of Appendicitis?
• How Is Appendicitis Diagnosed?
• What Is the Treatment for Appendicitis?
• What to Expect During an Appendectomy
• Appendicitis Complications
• Appendicitis Prevention
• More

Appendicitis is an inflammation of the appendix. It’s a medical emergency that almost always requires surgery as soon as possible to remove the appendix. Luckily, you can live just fine without it.

This 3 1/2-inch-long tube of tissue extends from your large intestine on the lower right side of your body. The appendix has specialized tissue that can make antibodies, but no one is completely sure what its function is.

In the U.S., 1 in 20 people will get appendicitis at some point in their lives. Although it can strike at any age, appendicitis is rare in children younger than 2. It’s most likely to affect people between the ages of 10 and 30.

Appendicitis happens when the appendix gets blocked, often by poop, a foreign body (something inside you that isn’t supposed to be there), or cancer. Blockage may also result from infection, since the appendix can swell in response to any infection in the body.

The classic symptoms of appendicitis include:

• Pain in your lower right belly or pain near your navel that moves lower. This is usually the first sign.
• Loss of appetite
• Nausea and vomiting soon after belly pain begins
• Swollen belly
• Fever of 99-102 F
• Can’t pass gas

Other less common symptoms of appendicitis include:

• Dull or sharp pain anywhere in your upper or lower belly, back, or rear end
• Painful or difficult peeing
• Vomiting before your belly pain starts
• Severe cramps
• Constipation or diarrhea with gas

If you have any of these symptoms, see a doctor right away. Timely diagnosis and treatment are important. Don’t eat, drink, or use any pain remedies, antacids, laxatives, or heating pads.

Diagnosing appendicitis can be tricky. Symptoms are often unclear or similar to those of other illnesses, including gallbladder problems, bladder or urinary tract infection, Crohn’s disease, gastritis, kidney stones, intestinal infection, and ovary problems.

These tests can help diagnose appendicitis:

• Examination of your abdomen to look for inflammation
• Urine (pee) test to rule out a urinary tract infection
• Rectal exam
• Blood test to see whether your body is fighting an infection
• CT scans
• Ultrasound

Appendicitis is almost always treated as an emergency. Surgery to remove the appendix, which is called an appendectomy, is the standard treatment for almost all cases of appendicitis.

Generally, if your doctor suspects that you have appendicitis, they will quickly remove it to avoid a rupture. If you have an abscess, you may get two procedures: one to drain the abscess of pus and fluid, and a later one to take out the appendix. But some research shows that treating acute appendicitis with antibiotics may help you avoid surgery.

Before your appendix is taken out, you’ll take antibiotics to fight infection. You’ll usually get general anesthesia, meaning you’ll be asleep for the procedure. The doctor removes your appendix through a 4-inch-long cut or with a device called a laparoscope (a thin telescope-like tool that lets them see inside your belly). This procedure is called laparoscopy. If you have peritonitis, the surgeon will also clean out your belly and drain the pus.

You can get up and move around within 12 hours after surgery. You should be able to go back to your normal routine in 2 to 3 weeks. If you had a laparoscopy, recovery is faster.

After an appendectomy, call your doctor if you have:

• Uncontrolled vomiting
• Increased belly pain
• Dizziness/feelings of faintness
• Blood in your vomit or pee
• Increased pain and redness where your doctor cut into your belly
• Fever
• Pus in the wound

Left untreated, an inflamed appendix will burst, spilling bacteria and debris into the abdominal cavity, the central part of your body that holds your liver, stomach, and intestines. This can lead to peritonitis, a serious inflammation of the abdominal cavity’s lining (the peritoneum). It can be deadly unless it is treated quickly with strong antibiotics and surgery to remove the pus.

Sometimes, an abscess forms outside an inflamed appendix. Scar tissue then “walls off” the appendix from the rest of your organs. This keeps the infection from spreading. But an abscessed appendix can tear and lead to peritonitis.

There’s no way to prevent appendicitis. But it may be less common in people who eat foods high in fiber, such as fresh fruits and vegetables.

Top Picks

Early Symptoms, Causes, Pain Location, Surgery, Recovery

Written by WebMD Editorial Contributors

• What Is Appendicitis?
• Where Is Your Appendix?
• What Causes Appendicitis?
• What Are the Symptoms of Appendicitis?
• How Is Appendicitis Diagnosed?
• What Is the Treatment for Appendicitis?
• What to Expect During an Appendectomy
• Appendicitis Complications
• Appendicitis Prevention
• More

Appendicitis is an inflammation of the appendix. It’s a medical emergency that almost always requires surgery as soon as possible to remove the appendix. Luckily, you can live just fine without it.

This 3 1/2-inch-long tube of tissue extends from your large intestine on the lower right side of your body. The appendix has specialized tissue that can make antibodies, but no one is completely sure what its function is.

In the U.S., 1 in 20 people will get appendicitis at some point in their lives. Although it can strike at any age, appendicitis is rare in children younger than 2. It’s most likely to affect people between the ages of 10 and 30.

Appendicitis happens when the appendix gets blocked, often by poop, a foreign body (something inside you that isn’t supposed to be there), or cancer. Blockage may also result from infection, since the appendix can swell in response to any infection in the body.

The classic symptoms of appendicitis include:

• Pain in your lower right belly or pain near your navel that moves lower. This is usually the first sign.
• Loss of appetite
• Nausea and vomiting soon after belly pain begins
• Swollen belly
• Fever of 99-102 F
• Can’t pass gas

Other less common symptoms of appendicitis include:

• Dull or sharp pain anywhere in your upper or lower belly, back, or rear end
• Painful or difficult peeing
• Vomiting before your belly pain starts
• Severe cramps
• Constipation or diarrhea with gas

If you have any of these symptoms, see a doctor right away. Timely diagnosis and treatment are important. Don’t eat, drink, or use any pain remedies, antacids, laxatives, or heating pads.

Diagnosing appendicitis can be tricky. Symptoms are often unclear or similar to those of other illnesses, including gallbladder problems, bladder or urinary tract infection, Crohn’s disease, gastritis, kidney stones, intestinal infection, and ovary problems.

These tests can help diagnose appendicitis:

• Examination of your abdomen to look for inflammation
• Urine (pee) test to rule out a urinary tract infection
• Rectal exam
• Blood test to see whether your body is fighting an infection
• CT scans
• Ultrasound

Appendicitis is almost always treated as an emergency. Surgery to remove the appendix, which is called an appendectomy, is the standard treatment for almost all cases of appendicitis.

Generally, if your doctor suspects that you have appendicitis, they will quickly remove it to avoid a rupture. If you have an abscess, you may get two procedures: one to drain the abscess of pus and fluid, and a later one to take out the appendix. But some research shows that treating acute appendicitis with antibiotics may help you avoid surgery.

Before your appendix is taken out, you’ll take antibiotics to fight infection. You’ll usually get general anesthesia, meaning you’ll be asleep for the procedure. The doctor removes your appendix through a 4-inch-long cut or with a device called a laparoscope (a thin telescope-like tool that lets them see inside your belly). This procedure is called laparoscopy. If you have peritonitis, the surgeon will also clean out your belly and drain the pus.

You can get up and move around within 12 hours after surgery. You should be able to go back to your normal routine in 2 to 3 weeks. If you had a laparoscopy, recovery is faster.

After an appendectomy, call your doctor if you have:

• Uncontrolled vomiting
• Increased belly pain
• Dizziness/feelings of faintness
• Blood in your vomit or pee
• Increased pain and redness where your doctor cut into your belly
• Fever
• Pus in the wound

Left untreated, an inflamed appendix will burst, spilling bacteria and debris into the abdominal cavity, the central part of your body that holds your liver, stomach, and intestines. This can lead to peritonitis, a serious inflammation of the abdominal cavity’s lining (the peritoneum). It can be deadly unless it is treated quickly with strong antibiotics and surgery to remove the pus.

Sometimes, an abscess forms outside an inflamed appendix. Scar tissue then “walls off” the appendix from the rest of your organs. This keeps the infection from spreading. But an abscessed appendix can tear and lead to peritonitis.

There’s no way to prevent appendicitis. But it may be less common in people who eat foods high in fiber, such as fresh fruits and vegetables.

Top Picks

Acute appendicitis | MyPathologyReport.ca

Madeleine Fitzpatrick, MD, and Stephanie Reed, MD, FRCPC
March 6, 2023

What is acute appendicitis?

Acute appendicitis is a non-cancerous disease caused by: acute inflammation in the appendix a small finger-shaped organ that connects to the large intestine (colon) through a small opening. For most people, the appendix is ​​located in the lower right side of the abdomen, just above the pelvic bone. Acute appendicitis can occur in any age group but most commonly affects teenagers and young adults.

What causes acute appendicitis?

In acute appendicitis, the small opening of the appendix is ​​blocked, often by a piece of overcooked food called feces. When the hole is blocked, bacteria that normally live in the colon fills up the appendix. Your immune system responds by sending specialized immune cells called neutrophils to surround and destroy the bacteria. The combination of bacteria and neutrophils leads to the formation of pus.

What are the symptoms of acute appendicitis?

Patients with acute appendicitis usually experience gradual, constant pain that starts near the navel and progresses to the right lower abdomen. Other possible symptoms may include nausea, vomiting, loss of appetite, diarrhea, and fever.

How is acute appendicitis diagnosed?

The diagnosis is made after the appendix is ​​surgically removed and sent to a pathologist for examination under a microscope. If your doctor suspects acute appendicitis, they will order a blood test and x-ray imaging, such as an ultrasound or CT scan. Your blood test usually shows a large number of immune cells called white blood cells (WBCs). An ultrasound or CT scan usually shows an enlarged appendix. Acute appendicitis is most often treated by removing the appendix.

What does acute appendicitis look like under a microscope?

When your pathologist examines your appendix under a microscope, he will look for specialized immune cells called neutrophils in the wall of your appendix. These neutrophils often combine with bacteria to form an abscess (pus). Neutrophils can also be seen on the outer surface of the appendix. Pathologists describe it as periappendicitis.

Observations and tips of this article we have prepared based on the experience of the team, the inflammation observed in acute appendicitis begins on the inside of the appendix, but spreads rapidly, affecting the wall and even the outer part of the appendix. The appendix can also swell, which blocks blood from getting in and out of the appendix. When this happens, parts of the appendix may begin to die due to a process called necrosis.

Acute appendicitis. This low magnification microscopic image shows an appendix with signs of acute appendicitis.

What does perforated appendicitis mean?

If left untreated, a hole or perforation may form in the appendix, and material inside the appendix may enter the abdominal cavity. This release can cause an abscess to form around the appendix.

What does periappendicitis mean?

Periappendicitis refers to inflammation on the outer surface of the appendix. Periappendicitis is a very common finding in acute appendicitis.

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clinical case, patient history of the clinic JSC “Medicina” in Moscow

Surgeon, coloproctologist, oncologist

Skorkina

Irina Konstantinovna

Experience 16 years

Doctor of the highest category, member of the European Society of Surgeons

Make an appointment

Patient S. , 45 years old.

Complaints on admission:

pulling pains in the lower abdomen;

nausea;

bloating.

Medical history.

I was sick during the day, when there was pain in the lumbar region, discomfort in the epigastric region, pain in the left hypochondrium.

The ambulance team diagnosed intercostal neuralgia, introduced “Tramadol”, “Baralgin” and “Platifillin” – the pain syndrome was stopped.

On the day of admission, there was pain in the lower abdomen, bloating, fever up to 37.5°C. Notes similar bouts of pain before.

Anamnesis of life.

Chronic calculous cholecystitis.

Chronic iron deficiency anemia against the background of polymenorrhea for several years.

Objectively.

The condition is satisfactory. Skin and mucous membranes of normal color. Pulse 96 beats per minute, rhythmic, good filling. Respiratory rate 18 per minute. Body temperature 37.4°C. Breathing is vesicular, no wheezing. Tongue dry, covered with white coating. The abdomen is swollen, soft, moderately painful above the womb, in the mesogastric region. There are no peritoneal symptoms. Peristalsis is uniform, there are no pathological intestinal noises. Appendicular symptoms are negative. There is no dysuria. The symptom of tapping is negative on both sides. The chair is decorated, regular.

Instrumental and laboratory research.

Chest X-ray – no pathology.

Ultrasound of the abdominal organs – Echo-signs of diffuse changes in the liver (like fatty hepatosis) and pancreas, chronic calculous cholecystitis.

Ultrasound of the pelvic organs – Echo-signs of endometriosis of the uterine body, endocervix cysts, ovarian cysts (endometrioid?), The minimum amount of free fluid in the pelvic cavity.

Complete blood count – hemoglobin 105 g / l, leukocytes – 7.38 × 10 ⁹ g/l, stab – 4%, ESR – 16 mm/h.

Urinalysis – unchanged erythrocytes – 9 in p / sp.

Dynamic observation.

A state without dynamics – pain in the abdomen, more in the left hypochondrium, an increase in body temperature up to 38 ° C. Tongue dry, covered with white coating. The abdomen is swollen, moderately painful above the bosom. There was tension in the muscles of the anterior abdominal wall in the right iliac region. There are no peritoneal symptoms.

Increasing blood leukocytosis from 7×10 ⁹
up to 9×10 ⁹ , stab – from 4 to 8%.

Gynecological consultation.

Apoplexy of a cyst of the left ovary is suspected.

Additional diagnostics.

A CT scan of the abdominal organs was performed – CT signs of calculous cholecystitis.

Moderate signs of lipoid infiltration of the liver.

Indirect signs of pancreatitis.

Differential diagnostic series.

Acute appendicitis.

Apoplexy of a cyst of the left ovary.

Acute cholecystopancreatitis.

Acute appendicitis?

Apoplexy of a cyst of the left ovary.

Acute cholecystopancreatitis.

Indications for surgery – diagnostic laparoscopy.

Impossibility of establishment of the diagnosis by other methods.

The need for emergency intervention in confirming the diagnosis of acute appendicitis.

Progression of symptoms on the background of infusion, detoxification and antibiotic therapy.

The appearance of signs of tension in the right iliac region.

Diagnostic laparoscopy.

Under the ETN, after processing the surgical field, a 10 mm laparoscope was inserted through the umbilical ring. Insufflation CO ₂ . During the revision: in the small pelvis and between the loops of the small intestine, traces of lysed blood were drained. In the right iliac fossa, a loose infiltrate is determined, consisting of the dome of the caecum and the appendix, the latter is destructively changed and fixed to the parietal peritoneum. The infiltrate is divided, the appendix is ​​highlighted to the base. The mesentery was cut off using bipolar coagulation. At the base of the appendix, 3 Raeder’s loops were tightened. The appendix is ​​cut off, immersed in a container, removed. Sanitation of the abdominal cavity. Hemostasis control – dry. A drainage tube was installed in the small pelvis and brought out through an incision above the womb.