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Appendicitis is defined as an inflammation of the appendix, which is a 3 1/2-inch-long tube of tissue that extends from the large intestine. It is a painful swelling of the appendix where stools are formed. It is caused by the obstruction of the appendiceal lumen (inside the appendix where mucus empties into the large intestine). Typically, appendicitis starts with a pain in the middle of the abdomen that may recur sporadically, coming and going. As the appendix lies to the lower right-hand side, within hours, the pain can be felt shooting in this region and can become constant and severe.


The most common causes of luminal obstruction include lymphoid hyperplasia or infections that are more common during childhood and in young adults, faecal stasis and faecoliths which are more common in elderly patients, parasites especially in eastern countries or more rarely foreign bodies and cancers.


The symptoms of appendicitis are:

  • The classical symptoms of loss of appetite and pain around the umbilicus followed by nausea, pain in the lower right area of abdomen and vomiting, which occurs in only 50% of cases.
  • Abdominal pain: most common symptom, typically begins around the middle part of the abdomen and then migrates to right lower region of abdomen.
  • Nausea and vomiting always precede pain.
  • Loss of Appetite is seen in 75% of patients.
  • The most specific sign is pain on percussion, rigidity in the right side of abdomen
  • Diarrhea
  • A high temperature (fever) and a flushed face

If you are experiencing such spasmodic pains, you can talk to a doctor in minutes before it becomes unbearable.


Diagnosis of Appendicitis includes:

  • WBC>10,500 cells, increase in neutrophil count
  • Ultrasonography abdomen is the primary diagnostic tool for appendicitis.
  • CT scan is used in the cases where ultrasonography is inconclusive

Appendectomy is the surgical removal of appendix, which is the only curative treatment of appendicitis. It can be done through laparoscopic procedure and in cases of complications it is done through open procedure. The treatment varies for an appendiceal mass, wherein an initial intravenous antibiotic therapy is administered and an interval appendectomy is performed 4-6 weeks later.

Complications can also result in appendicitis. If left untreated, appendicitis can lead to life threatening conditions. An inflamed appendix can burst releasing pus to other parts of the body, which can cause infection in the abdomen called peritonitis. If prompt medical intervention is not done, peritonitis can be fatal. Sometimes an abscess forms around a burst appendix which needs initial treatment with antibiotics and after an interval of 4-6 weeks it may require surgical removal.

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