Appendicitis

January 2017
Appendicitis is inflammation of the appendix. It is most common between the ages of 10 and 30 years and rare under the age of 5. Making a diagnosis in the under 5's is rather difficult .


Definition

Appendicitis is an inflammation of the appendix, a natural diverticulum extending from the first segment of the large intestine called the cecum. Appendicitis can affect all age groups. In its most typical form, it is an inflammation of the inner layer of this structure, the mucosa, following its obstruction and the development of germs within it. Acute appendicitis requires prompt surgical care to remove the organ, called appendectomy. Indeed, in the absence of treatment, the appendix can rupture into the peritoneal cavity that surrounds the abdominal organs, referred to as appendicular peritonitis.

Risks

Appendicitis can quickly develop into peritonitis: this is an acute abdominal infection causing severe abdominal pains and a very hard abdomen. Peritonitis is a very serious illness.

Symptoms

Appendicitis is usually associated with:
  • mild fever over 38 ∞ C;
  • pain in bottom right side of the abdomen, near the groin;
  • nausea and vomiting;
  • bowel dysfunction;
  • a tongue covered with a whitish coating.

Pain

Sudden and severe pain on the right side and the lower abdomen, the localisation of the appendix. The pain radiates down to the leg. It worsens when walking and coughing.

Other symptoms of appendicitis




Appendicitis is an emergency. Contact a doctor urgently or dial 999, or 911 depending on your local emergency number.

Atypical symptoms

Abdominal pain is not always on the right it can be diffuse and occur on the left because of the atypical position of the appendix. The symptoms of nausea and vomiting for are not always present.

What to do if faced with possible appendicitis

Do not offer food or drink... Consult urgently a doctor

A complication of appendicitis is peritonitis

Peritonitis is inflammation of the entire abdominal wall, which encases the stomach, small and large intestine. It is usually an infection that causes peritonitis and the abdomen becomes hard and is diffusely tender. Peritonitis is life threatening and needs urgent medical attention. A generalised infectious peritonitis begins in general with a pain in a particular point of the abdomen and then diffuses secondarily.

Emergency hospitalisation

Emergency hospitalisation is necessary for intravenous antibiotics, rehydration and possible surgical intervention.

Diagnosis

Abdominal pain is usually located at the bottom right of the abdomen and is the most usual sign of appendicitis. Pain can also be differed to other areas of the abdomen. A rectal examination, carried out by a doctor, will reawaken this pain.

Fever, when it is present, is in general around 38°-38°5, but seldom higher. Rapid pulse rate. Other symptoms like fever, constipation, nausea and vomiting for example can be symptoms of other pathology.

A full blood count is also necessary. An increase in the number of white cells indicates an infection of some kind.
  • Appendicitis can occur despite of a normal blood count
  • An increase in white cells can be caused by any type of infection
  • A reduction in white cells can also be sometimes a sign of appendicitis
  • An increase in CRP, is a sign of inflammation


A X-ray of the abdomen is a very useful examination which helps to exclude other pathologies and to confirm a diagnosis of appendicitis.

An ultrasound scan is more better at examining soft tissue and can reveal inflammation around the appendix, it can also help differentiate appendicitis from a gynaecological or urinary anomaly. Children are always closely monitored and only proceed to surgery if appendicitis is suspected.

Treatment

The surgery is performed as soon as possible to avoid any complications that could be detrimental to the health of the patient. Beforehand, the pain is relieved by analgesics, and antibiotics are started. During the operation, called an appendectomy, the appendix is removed and the peritoneal cavity is cleaned in case of perforation. An opening in the abdominal wall can be made. The patient is kept in the hospital for a few days.

Removal of the appendix called appendectomy is essential to treat the problem. Rehydration and antibiotics are also given. The main risk is that an appendicitis goes undetected and then develops into peritonitis. A doctor should always assess a sudden onset of abdominal pain located on the lower right hand side of the abdomen so that appendicitis can be excluded.

Related


Appendicite - Symptômes, diagnostic et traitement
Appendicite - Symptômes, diagnostic et traitement
Apendicitis
Apendicitis
Blinddarmentzündung
Blinddarmentzündung
This document, titled "Appendicitis," is available under the Creative Commons license. Any copy, reuse, or modification of the content should be sufficiently credited to CCM Health (health.ccm.net).