Appendicitis and appendectomy or appendicectomy
Types, causes, symptoms, complications, diagnosis and treatment

What is appendicitis?

Appendix is a finger-sized, thin sac or pouch structure, located at the lower end of the large intestine. It is present in the lower right area of the abdomen. While it does not play any potential role in adults, it may have an immune-function in young children. Inflammation of the appendix is known as appendicitis.

What is appendicitis

Appendicitis is often confused with epiploic appendagitis, (also known as appendicitis epiploica or epiplopericolitis), an inflammatory condition of the large intestine, as both these conditions cause a sudden pain in the abdomen.

What are the types of appendicitis?

• Acute Appendicitis– Sudden appendix pain in the abdomen.
• Sub-Acute Appendicitis– The pain of acute appendicitis tends to subside spontaneously.
• Chronic Appendicitis– An old, healed acute appendicitis, shows scarring and thickening of the walls.
• Recurrent Appendicitis– Episodes of pain which re-occur after subsiding.
• Non-Obstructive Appendicitis– Not critical, however, in some cases it may cause swelling and thickening of membrane that covers all abdominal organs.This is called as peritonitis

What causes appendicitis?

The exact cause of appendicitis is not known, but the main cause is believed to be blockage of the appendix due to food or faeces or gastrointestinal infection, leading to inflammation and swelling of the appendix.

What are the signs and symptoms of appendicitis?

Appendicitis may start with a mild, on and off pain in the stomach that travels to the lower right side, around the location of the appendix. This pain may gradually become severe and constant.

Signs and symptoms of appendicitis may differ from person to person. The most common symptom is severe pain in the lower-right abdomen, other symptoms may include

• Bloating of stomach
• Constipation or diarrhoea
• Loss of appetite
• Low-grade fever (temperature ranges between 100.2˚F to 102.2˚F), may increase gradually
• Nausea and vomiting
• Weakness

Symptoms of appendicitis in adults:

A sudden pain that originates in the lower right side of the abdomen or near the navel and then shifting to the lower right abdomen is a common symptom of appendicitis in adults. Movements like coughing or walking or those causing jarring aggravate the pain.

Symptoms of appendicitis in children:

Signs and Symptoms of Appendicitis

Pain beginning in the belly button area and moving to the lower right abdomen area is a common symptom of appendix in children. With pain, the child may also present with fever and “rebound tenderness,” which is a sharp pain that develops on applying pressure on the lower right area and then releasing immediately.

What are the complications of appendicitis?

Appendicitis, if not treated in time, may lead to bursting of the appendix, which can cause complications

• Peritonitis and infection: Inflammation and spread of infection throughout the abdomen. Needs emergency treatment as it can be life threatening.
• Abscess: Formation of localized pus in the abdomen requiring drainage.

How is appendicitis diagnosed?

Your surgeon may be able to diagnose appendicitis by:

• Medical history; right abdominal pain (appendix pain area) being one of the hallmarks of appendicitis
• Physical examination including assessment of the pain by pressing specific areas of the abdomen.
• Laboratory tests:
  • Blood test
  • Urine test
• Imaging tests:
• Ultrasound
• Magnetic Resonance Imaging (MRI)
• Computerized tomography (CT) scan

Diagnosis of Appendicitis

How is appendicitis treated?

While selecting a hospital for treatment of appendicitis, look for a hospital with a trained team of surgeons, anaesthetists, nursing and support staff with infrastructure like modern operation theatres, laboratory and ICU for management of emergencies. Depending on the signs and symptoms and the medical condition of the patient, appendicitis may be managed conservatively or surgically.

• Medications like pain killers and antibiotics
• Surgery: Appendectomy or appendicectomy is the surgery for removal of appendix carried out under general anaesthesia. It can be done as an open surgery or a laparoscopic procedure.
• Laparoscopy: The infected appendix, when it has not burst, can be removed with the help of key-hole surgery or laparoscopy (a tube containing a light source and a camera)
• Open surgery: Recommended especially when the appendix has burst or the infection has spread in the abdomen or in case of an abscess. A single large cut or incision is made in the abdomen and the appendix is then removed.
• Abscess drainage: When the appendix has burst, and an abscess has formed around it, the doctor needs to drain out the pus from the body and treat the infection with an antibiotic, before an open surgery is carried out. Once the infection is resolved, the surgery can be conducted.

To know more about appendicitis, you can request for a call back and our appendicitis specialist will call you and answer all your queries.

References:

• Mayo Clinic. Appendicitis. Available at: https://www.mayoclinic.org/diseases-conditions/appendicitis/diagnosis-treatment/drc-20369549. Accessed on 05^th March 2018.
• Acute appendicitis in adults: Clinical manifestations and differential diagnosis: Available at: https://www.uptodate.com/contents/acute-appendicitis-in-adults-clinical-manifestations-and-differential-diagnosis?.  Accessed on 05^th March 2018.
• National Institute of Diabetes and Digestive and Kidney diseases. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/appendicitis/treatment. Accessed on 05^th March 2018.
• US National Library of Medicine National Institute of Health. Clinical value of the total white blood cell count and temperature in the evaluation of patients with suspected appendicitis. Available at: https://www.ncbi.nlm.nih.gov/pubmed/15466143. Accessed on 05^th March 2018.
• National Health Service. Appendicitis. Available at: https://www.nhs.uk/conditions/appendicitis/treatment/. Accessed on 05^th March 2018.

Disclaimer:

“The content of this publication has been developed by a third party content provider who is clinicians and/or medical writers and/or experts. The information contained herein is for educational purpose only and we request you to please consult a Registered Medical Practitioner or Doctor before deciding the appropriate diagnosis and treatment plan.”