Appendicitis

Appendicitis is a condition that’s caused by inflammation or infection of the appendix. The appendix is a small pouch that sits where the small intestine joins the large intestine. Doctors aren’t sure what the purpose of the appendix is, but an infected appendix can be severely painful, and appendicitis can be life-threatening.

Doctors do not view a healthy appendix as a critical part of the human body. However, a blockage of the appendix can cause inflammation and infection, a condition known as appendicitis. Appendicitis symptoms can be quite painful. Left untreated, the appendix can burst, leading to additional complications.

A ruptured appendix carries the risk of spreading infection throughout the abdominal cavity and the rest of the body. A localized pocket of infection, or abscess, is another possible risk of untreated appendicitis. Without appropriate treatment, a ruptured appendix can lead to death.

Appendicitis is most often recognized by its early warning signs:

• Localized and sudden pain in the lower right abdomen
• Pain that begins around the belly button then moves to the lower right abdomen
• Nausea, vomiting or loss of appetite
• Abdominal bloating or gas
• Constipation or diarrhea
• A low-grade fever that worsens as other symptoms progress

The presence of abdominal pain in appendicitis typically gets worse with activity. Although the lower right abdomen is the most common area for people to experience early pain and symptoms of appendicitis, the exact location can vary depending on your age and the location of your appendix. For example, the appendix is positioned higher during pregnancy, so pregnant women can experience upper abdominal appendicitis symptoms.

There are no standard risk factors associated with appendicitis. Most cases of appendicitis occur between the ages of 10 and 30. Men may carry a higher risk for getting appendicitis if they have a family member who has also had appendicitis. There could also be a connection between childhood cystic fibrosis and appendicitis.

Diagnosing appendicitis begins with a physical exam. Your doctor will check the abdomen for rigidity, and to see if pain increases when he or she applies pressure. In some cases, your doctor may perform a digital rectal exam. For women, doctors may perform a pelvic exam as well.

Additional tests your doctor may order include:

• Outpatient laboratory tests, such as checking the blood or urine for signs of infection
• Imaging tests such as an X-ray, MRI, ultrasound or CT scan

These diagnostic tests can be used to help your doctor either confirm the presence of appendicitis or identify a different cause for your abdominal pain.

The most common treatment for appendicitis is a complete surgical removal of the appendix. This type of surgery is called an appendectomy. There are two surgical approaches for performing an appendectomy:

• Traditional open surgery requires your surgeon to cut an incision in the lower right-hand abdomen that’s large enough to access and remove the appendix.
• Minimally invasive surgery for appendicitis can mean a smaller incision and faster healing time in the right candidates. This approach to treating appendicitis uses a tiny camera so your surgeon can remove the appendix without opening the entire abdomen.

If the appendix has already burst, your doctor will also clean out the abdominal cavity as part of your appendectomy. Your surgeon may also place a shunt, which is a small tube to help pus and other fluids drain out of the body. The shunt can be removed after a few days.