The appendix is a small pouch attached to the large intestine. The appendix is a small, finger-shaped pouch of intestinal tissue located between the small intestine (cecum) and large intestine (colon). The appendix is a small finger-shaped tube that branches off the first part of the large intestine.
Appendicitis (means append=appendix and itis=inflammation. Appendicitis causes pain in your lower right abdomen. However, in most people, pain begins around the navel and then moves. As inflammation worsens, appendicitis pain typically increases and eventually becomes severe.
Although anyone can develop appendicitis, most often it occurs in people between the ages of 10 and 30. Standard treatment is surgical removal of the appendix.
Signs and symptoms of appendicitis may include:
- Sudden pain that begins on the right side of the lower abdomen
- Sudden pain that begins around your navel and often shifts to your lower right abdomen
- Pain that worsens if you cough, walk or make other jarring movements
- Nausea and vomiting
- Loss of appetite
- Low-grade fever that may worsen as the illness progresses
- Constipation or diarrhea
- Abdominal bloating
- Flatulence
The site of your pain may vary, depending on your age and the position of your appendix. When you’re pregnant, the pain may seem to come from your upper abdomen because your appendix is higher during pregnancy.
Strongly suggestive of appendicitis is pushing down on the R lower quadrant and upon letting go the pain is severe compared to when pushing down. It is called “rebound effect”.
Diagnostic Tests for confirming appendicitis:
- Blood test. This allows your doctor to check for a high white blood cell count, which may indicate an infection.
- Urine test. Your doctor may want you to have a urinalysis to make sure that a urinary tract infection or a kidney stone isn’t causing your pain.
- Rectal exam
- Imaging tests. Your doctor may also recommend an abdominal X-ray, an abdominal ultrasound, computerized tomography (CT) scan or magnetic resonance imaging (MRI) to help confirm appendicitis or find other causes for your pain.
Treatment:
Appendicitis treatment usually involves surgery to remove the inflamed appendix. Before surgery you may be given a dose of antibiotics to treat infection. There are times though antibiotics may only be used and the MD see’s if the appendicitis is resolved; it depends on the MD and the severity of the appendicitis.
Surgery to remove the appendix (appendectomy)
Appendectomy can be performed as open surgery using one abdominal incision about 2 to 4 inches (5 to 10 centimeters) long (laparotomy). Or the surgery can be done through a few small abdominal incisions (laparoscopic surgery). During a laparoscopic appendectomy, the surgeon inserts special surgical tools and a video camera into your abdomen to remove your appendix.
In general, laparoscopic surgery allows you to recover faster and heal with less pain and scarring. It may be better for older adults and people with obesity.
But laparoscopic surgery isn’t appropriate for everyone. If your appendix has ruptured and infection has spread beyond the appendix or you have an abscess, you may need an open appendectomy, which allows your surgeon to clean the abdominal cavity.
Expect to spend one or two days in the hospital after your appendectomy.
Draining an abscess before appendix surgery
If your appendix has burst and an abscess has formed around it, the abscess may be drained by placing a tube through your skin into the abscess. Appendectomy can be performed several weeks later after controlling the infection.