Appendicitis occurs when the appendix fills with pus and becomes inflamed. The appendix is located on the lower right side of the abdominal cavity, protrudes from the colon, and is finger-shaped. Its exact purpose in the body is unknown, but when it becomes inflamed it can cause severe problems. Appendicitis attack symptoms tend to get worse over a 12 to 18-hour period and will eventually become very severe.
This condition most often occurs in people 10 to 30 years of age, but it can affect people of all ages. The cause of this condition isn’t always known, but two things often result in appendicitis. Sometimes a hard piece of fecal matter or food waste gets stuck in one of the orifices in the cavity that contains the appendix. An infection may also cause this condition. One example of an infection that can cause appendicitis is a gastrointestinal viral infection. Other types of inflammation may cause inflammation of the appendix, leading to appendicitis.
Both causes can lead to bacteria rapidly invading the appendix, resulting in the inflammation of the appendix. If it is not treated quickly, the appendix will rupture.
Patients experiencing any of the following appendicitis attack symptoms should seek medical attention immediately. Do not wait until the symptoms become severe. These symptoms include:
- Pain (will get worse when the patient takes deep breaths, moves, sneezes, or coughs)
- The feeling that the discomfort will be alleviated by having a bowel movement
- Loss of appetite
- Abdominal swelling
- Low-grade fever that starts after other symptoms have begun
- Not being able to pass gas
- Diarrhea or constipation
Not all patients will experience all symptoms, but most will experience pain in the lower right side of the abdominal cavity. Nausea is also common.
Patients who are not diagnosed promptly are at risk for complications. These complications are serious and include a pocket of pus forming in the abdominal cavity and a ruptured appendix. The pocket of pus, medically referred to as an appendiceal abscess, occurs when the seepage of intestinal contents and infection form an abscess. If this is not treated prior to the abscess tearing, a widespread abdominal cavity infection could result.
A ruptured appendix leads to infectious organisms and intestinal contents leaking into the abdominal cavity. This can lead to peritonitis, a potentially dangerous abdominal cavity infection.
In some cases, a diagnosis can be difficult because the pain may change over time. The first thing a doctor will do is ask the patient about their symptoms and perform a thorough physical exam. They will then measure the patient’s white blood cell count, by having them get a blood test, to see if they are high which can mean there is an infection present.
A urine test may be performed to see if the patient has a kidney stone or urinary tract infection because if they do it could be the cause of their pain. Imaging, such as an ultrasound of the abdominal cavity, an abdominal X-ray, or a CT scan (computerized tomography) may be done to rule out other conditions that may be causing the pain or to confirm appendicitis.
Surgery to remove the appendix is the most common treatment. This surgery involves making a single two to four inch abdominal incision to remove the appendix through. If the doctor chooses to perform a laparoscopic appendix removal, several small incisions are made in the abdomen. Then a video camera and special surgical tools are inserted into the small incisions to remove the appendix. Most patients will spend approximately two days in the hospital for recovery.
Patients with an abscess will have a tube placed into the abscess through the skin to drain it. Then the appendix will be removed once the infection is completely cleared.
Mayo Clinic. (2009). Appendicitis. Retrieved on January 27, 2010 from the Mayo Clinic: https://www.mayoclinic.com/health/appendicitis/DS00274
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