Appendicitis

General Illness Information

Common Name:
APPENDICITIS

Medical Term: None Specified

Description: Appendicitis is the inflammation of the appendix, a small intestinal pouch (a finger shaped structure) that extends from the cecum, the first part of the large intestine. The appendix has no known function, but it can become diseased.

Appendicitis affects 1 in 500 people each year. Appendicitis should be considered in any person with undiagnosed abdominal pain. It affects all ages (men more than women), but is rare in children under 2. The incidence peaks between ages 15 and 24.

Causes:

  • Infection for unknown reason, usually with bacteria from the intestinal tract.
  • The appendix may become obstructed from contents moving through intestinal tract, or by a constricting band of tissue.
  • When infected, it becomes swollen, inflamed and filled with pus.

Prevention:

No specific preventive measures.

Signs & Symptoms

  • Pain that begins around the navel and then moves toward the right lower abdomen. Pain becomes persistent and well localized. It worsens with moving, breathing deeply, coughing, sneezing, walking, or being touched. In infants and children, the pain be generalized rather than being confined to the right lower abdomen.
  • Nausea and vomiting.
  • Low grade fever, beginning after other symptoms.
  • Constipation and inability to pass gas (occasionally).
  • Diarrhea (occasionally).
  • Tenderness in the right lower abdomen, usually about a third of the distance from the navel to the top of the hip bone.
    Abdominal swelling (late stages)
  • Increased white blood-cell count.

Risk Factors

Treated for a recent illness, especially a roundworm infestation or gastrointestinal virus infection.

Diagnosis & Treatment

General Measures:

  • Usually the physician bases the diagnosis on his/her physical examination
  • Diagnostic tests may include laboratory blood studies. Blood cell count usually shows higher levels of white blood cells. Also urinalysis is done to rule out a urinary-tract infection, which can mimic appendicitis.
  • Tests such as abdominal ultrasound, x-rays. CT scans may be ordered but are useless in early appendicitis
  • While diagnosis is uncertain, take your temperature every 2 hours. Keep a record.
  • Surgery to remove the appendix (appendectomy). Because appendicitis can be hard to diagnose, surgery is often withheld until symptoms and signs progress enough to confirm the diagnosis. However, delaying surgery until the doctor is sure of the diagnosis can be fatal because an infected appendix may rupture within 24 hours from onset of symptoms. In fact, in 15% of the operations for appendicitis the appendix is found to be normal- appendectomy is still performed. The surgeon will then proceed to examine the abdomen to determine the cause of the pain.
  • If an abscess has formed, surgery may be delayed until the abscess is drained and has time to heal.

Medications:

  • Don’t take any laxatives, enemas or medicines for pain. Laxatives may cause rupture, and pain or fever reducers make diagnosis more difficult.
  • Pain medicine will be prescribed after surgery.
  • Antibiotics if infection is present.

Activity:

Rest in a bed or chair until surgery. Resume normal activities gradually after surgery.

Diet:

  • Don’t eat or drink anything until appendicitis has been diagnosed. Anesthesia for surgery is much safer if the stomach is empty. If you are very thirsty, wash your mouth out with water.
  • A liquid diet, progressing to soft diet following surgery.

Possible Complications:

  • Rupture of the appendix, abscess formation and peritonitis. This is more common in older persons.
  • Misdiagnosis because of few or atypical symptoms especially in the very young or very old.
  • Formation of an abscess.

Prognosis

With early diagnosis and surgery, patients make a complete recovery and are able to leave the hospital in 2 to 3 days.

The prognosis is more serious if the appendix is ruptured. In such a case, the patient may require repeated surgeries and antibiotics and convalescence is much longer.