Acute Appendicitis

Acute Appendicitis

Appendicitis is a painful swelling of the appendix. Most cases of appendicitis happen between the ages of 10 and 30 years. Despite diagnostic and therapeutic advancement in medicine, appendicitis remains a clinical emergency and is one of the more common causes of acute abdominal pain.

Signs / Symptoms

What's common signs of acute appendicitis ?

  • Sudden pain in the middle of abdomen that travels to the lower right-hand side within hours and may be worsening while cough, walk or make other jarring movements
  • Loss of appetite
  • Nausea and vomiting
  • Low-grade fever that may worsen as the illness progresses
  • Constipation or diarrhea, 
  • Abdominal bloating
  • Flatulence

Common causes

What's common causes of acute appendicitis?

Obstruction of the appendiceal lumen is thought as a cause. most common causes of luminal obstruction:

  • Lymphoid hyperplasia 
  • Infections (specially childhood and in young adults),
  • Fecal stasis and fecaliths (commonly in elderly patients), 
  • parasites (especially in Eastern countries), 
  • Foreign bodies and neoplasms as rarely

Departments & Emergency

The classic history of anorexia and periumbilical pain followed by nausea, right lower quadrant (RLQ) pain, and vomiting occurs in only 50% of cases. If a person have sudden pain in the middle of abdomen that travels to the lower right-hand side within hours along with one or more symptoms it is recommended to go to Emergency. Severe abdominal pain requires immediate medical attention.

Diagnosis

Predominantly based on present with a typical history and examination findings. 

  • Pelvic exam
  • Blood test to look for signs of infection
  • Pregnancy test for women to rule out pregnancy
  • Urine test to rule out other conditions, such as a bladder infection

Imaging tests to whether if appendix has swollen

Treatment

Removing the appendix (appendectomy) is usually recommended if appendicitis is suspected, rather than risk it bursts. Appendectomy can be performed as open surgery using one abdominal incision about 2 to 4 inches (5 to 10 centimeters) long (laparotomy). Or the surgery can be done through a few small abdominal incisions (laparoscopic surgery). During a laparoscopic appendectomy, the surgeon inserts special surgical tools and a video camera into your abdomen to remove your appendix.

In general, laparoscopic surgery allows you to recover faster and heal with less pain and scarring. It may be better for older adults and people with obesity.

But laparoscopic surgery isn’t appropriate for everyone. If your appendix has ruptured and infection has spread beyond the appendix or you have an abscess, you may need an open appendectomy, which allows your surgeon to clean the abdominal cavity.

Expect to spend one or two days in the hospital after your appendectomy.

FAQ

What is the difference between chronic appendicitis and acute appendicitis?

Chronic appendicitis can have milder symptoms for a long time, it can go undiagnosed for a time. Acute appendicitis has more severe symptoms within 24 to 48 hours and need treatment immediately.

Is acute appendicitis an emergency?

Appendicitis is almost always considered as an emergency.

Is it harmful to remove the appendix?

According to known literature removing it is not harmful.

Can appendicitis be prevented?

At this time, there is no known way to stop appendicitis from happening. But you might be able to lower your risk of developing it by eating a fiber-rich diet. Although more research is needed on the potential role of diet, appendicitis is less common in countries where people eat high-fiber diets.

Foods that are high in fiber include:

  • fruits
  • vegetables
  • lentils, split peas, beans, and other legumes
  • oatmeal, brown rice, whole wheat, and other whole grains
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