Appendicitis: Causes, Symptoms and Treatment
Appendicitis is an inflammation of the appendix, a small pouch attached to the large intestine. It causes severe abdominal pain and usually requires surgical treatment.
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Appendicitis is an inflammation of the appendix, a small pouch attached to the large intestine. It causes severe abdominal pain and usually requires surgical treatment.
What is Appendicitis?
Appendicitis is an inflammation of the appendix (appendix vermiformis), a small, finger-shaped pouch located at the junction of the small and large intestine in the lower right abdomen. It is one of the most common surgical emergencies worldwide and can affect people of all ages, although it occurs most frequently in children, teenagers, and young adults. Without prompt treatment, appendicitis can lead to serious and life-threatening complications.
Causes
The exact cause of appendicitis is not always clear, but the following factors are commonly involved:
- Blockage of the appendix opening: Hardened stool (fecaliths), mucus, or foreign objects can obstruct the appendix lumen.
- Bacterial infection: Bacteria can invade the appendix wall, triggering an inflammatory response.
- Swollen lymph nodes: Enlarged lymph nodes near the intestine, often following a gastrointestinal infection, can compress the appendix.
- Parasites or foreign bodies: In rare cases, parasites or swallowed foreign objects may cause a blockage.
Symptoms
Symptoms of appendicitis typically develop over a few hours and may worsen rapidly:
- Abdominal pain: Often begins around the navel and migrates to the lower right abdomen (the McBurney point).
- Nausea and vomiting
- Fever (typically between 38 and 39 degrees Celsius)
- Loss of appetite
- Abdominal rigidity when the abdomen is touched
- Rebound tenderness: Pain that worsens when pressure on the abdomen is quickly released
In older adults, pregnant women, and young children, symptoms may be atypical and more difficult to diagnose.
Diagnosis
The diagnosis of appendicitis is based on a combination of clinical examination, laboratory tests, and imaging studies:
- Physical examination: Assessment of tenderness at the McBurney point, rebound tenderness, and abdominal rigidity.
- Blood tests: Elevated CRP (C-reactive protein) and increased white blood cell count (leukocytosis) indicate inflammation.
- Ultrasound: The preferred initial imaging method, especially in children and pregnant women.
- CT scan (computed tomography): Used when ultrasound results are inconclusive; highly accurate for diagnosing appendicitis.
- MRI: An alternative to CT for pregnant patients to avoid radiation exposure.
Treatment
Surgical Treatment (Appendectomy)
The standard treatment for appendicitis is surgical removal of the appendix, known as an appendectomy. This is most commonly performed as a minimally invasive laparoscopic procedure (keyhole surgery), which allows for faster recovery. In some cases, open surgery may be necessary, particularly when complications such as perforation have occurred.
Conservative Treatment
In cases of uncomplicated appendicitis without perforation, treatment with antibiotics alone may be considered as an alternative to surgery. However, this approach is not suitable for all patients and requires careful monitoring, as there is a risk of recurrence.
Complications
If appendicitis is not treated promptly, serious complications can develop:
- Perforation (rupture): The inflamed appendix bursts, releasing bacteria into the abdominal cavity.
- Peritonitis: A life-threatening inflammation of the lining of the abdominal cavity, resulting from perforation.
- Abscess: A localized collection of pus within the abdominal cavity.
References
- Longo, D. L. et al. - Harrison's Principles of Internal Medicine, 20th edition. McGraw-Hill Education, 2018.
- Andersen, B. R. et al. - Antibiotics versus placebo for prevention of postoperative infection after appendicectomy. Cochrane Database of Systematic Reviews, 2005. Available at: pubmed.ncbi.nlm.nih.gov
- Di Saverio, S. et al. - Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines. World Journal of Emergency Surgery, 2020. Available at: wjes.biomedcentral.com
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Related search terms: Appendicitis + Inflammation of the Appendix + Appendix Inflammation