Appendicitis

The appendix is a small, finger-shaped pouch that sticks out from your colon on the right side. (See the belly image). The appendix has no known purpose anymore, (maybe it did a long time ago), but that doesn’t mean it can’t cause problems. Every year about 7 percent of Americans develop appendicitis, a condition in which the appendix becomes inflamed and filled with pus.

Appendicitis can occur at any age but it most often affects people between the ages of 10 and 30 and is one of the most common reasons for emergency abdominal surgery in children. Males are slightly more affected than females.

Signs and Symptoms

The main symptom of appendicitis is pain that begins centered around the belly button, which later shifts to the right side of the abdomen. The pain usually increases over a period of about 6 - 10 hours, BUT this can vary and eventually the pain may be very severe. The location of your pain may also vary, depending on your age. Young children may have appendicitis pain in different places. In addition to pain, you may have one or more of the following symptoms:

 Pain that begins centered around the belly button, then localizes to the right side

 Loss of appetite
 Nausea and sometimes vomiting
 A fever that starts after other symptoms appear

Diagnosis

The diagnosis of appendicitis is best made on the basis of a history of the symptoms and a physical exam. When pressure on the painful area is suddenly released, appendicitis pain will often feel worse! Blood tests may show an elevation in the white blood cell count.

An x-ray of the abdomen, ultrasound or CAT scan may be helpful in certain cases. Other diseases can mimic symptoms of appendicitis, some of these include: pelvic inflammatory disease (PID), kidney stones, an ovarian cyst or an ectopic pregnancy. As you can see it’s important to know what’s really causing the pain and that’s what the scans will help determine for the physician. If you’re female, a pelvic exam will be done to determine the exact location of your pain and to rule out PID, ovarian cyst, or an ectopic pregnancy (a pregnancy outside of the uterus, usually in the fallopian tube.)

Complications

The most serious complication of appendicitis is an infection of the lining of your abdominal cavity, this is called peritonitis. Peritonitis is a medical emergency!!! If you or a family member develops signs of this abdominal infection, go to an emergency room right away. Even with prompt treatment, peritonitis can be extremely serious. Call 911 if that wil get you to the hospital faster or if you cannot drive to an emergency room.

Treatment

If you have acute appendicitis, you’ll need to have your appendix surgically removed (an appendectomy). Your surgeon may perform traditional open surgery, using a single abdominal incision, or choose laparoscopic surgery, which requires only a few small abdominal incisions. It often depends upon how soon the diagnosis is made. In general, laparoscopic surgery will allow you to recover faster and heal with less scarring.

If your appendix has ruptured and infection has spread beyond the appendix, a larger incision will be needed so your surgeon can clean the abdominal cavity. You’ll receive intravenous antibiotics to treat the infection and you will need to stay in the hospital during your recovery. Don’t worry about pain after your surgery, you’ll be given medication to control any postoperative pain.

Check out Abdominal Pain in Adults, if you think you have other pain and see your health care provider.