Summary
- Appendicitis is inflammation of the appendix
- If untreated, an inflamed appendix can burst, causing infection and even death
- Anyone with symptoms should see a doctor immediately
- Treatment entails surgical removal of the appendix
Description
The appendix is a small, hollow tube-like structure attached to the lower right side of the colon. The lumen (cavity) of the appendix opens into the colon where it is attached to the colon, and is closed at the other end. Although the appendix does not seem to serve any purpose, it can still become
diseased. Appendicitis is inflammation of the appendix.
If untreated, an inflamed appendix can burst, causing infection and even death.
Cause Appendicitis may occur after a viral infection
in the digestive tract or when the appendix is blocked by trapped stool. It
can also sometimes be caused by blockage of the appendix by a worm. A
blockage of the appendix causes accumulation of secretions in the appendix,
which can then become inflammed or infected. The inflammation can cause
infection, a blood clot, or rupture
of the appendix. Because of the risk of
rupture, appendicitis is considered an emergency. Anyone with symptoms needs to
see a doctor immediately.
Symptoms
The person experiences pain in the lower right side of the abdomen. The pain usually begins near the
navel and moves down and to the right. The pain becomes worse when moving, taking
deep breaths, coughing, sneezing, and being touched in the area. The pain is
usually accompanied with nausea, vomiting, loss of appetite, constipation or
diarrhoea. A slight abdominal swelling may also be seen. Low grade fever may
begin after all the other symptoms are present.
Symptoms may take from four to 48 hours to develop. Not everyone has all the symptoms and the pain is not always as described above. This can make it difficult to diagnose. It
is important that persons with symptoms of appendicitis should not take laxatives
or enemas to relieve constipation because these medicines could cause the appendix
to burst. People should also not take pain medicine because it can mask symptoms
that the doctor needs to know about. Children and the elderly often may show
only a few symptoms, such as a tender abdomen or a loss of appetite.
Prevalence
About 1 in 500 people has appendicitis each year.
Course
An inflamed appendix left unattended may proceed to a
burst appendix, which is considered a medical emergency. With a burst appendix
the rest of the abdominal cavity may become soiled with the colon contents. This
causes widespread infection of the abdominal cavity known as peritonitis.
Risk Factors
No risk factors are known.
Diagnosis
The doctor bases an appendicitis diagnosis on symptoms, a physical exam, blood
tests to check for signs of infection such as a high white blood cell count,
and urine tests to rule out a urinary tract infection. Some doctors use ultrasound
to see whether the appendix looks inflamed.
Treatment
Home
Seek medical assistance as soon as the abdominal pain increases, becomes continuous,
or occurs on walking or urinating. Keep the patient lying down, and comfortable. An ice pack placed over the painful area may be of help. When complaining
of thirst let him/her rinse their mouth with water without swallowing. Don't give any food.
Medications
No purgatives or laxatives or any over-the-counter remedies should be given
before the diagnosis is confirmed.
Surgery
Treatment of appendicitis entails surgical removal of the appendix, called an
appendectomy. Many doctors use a laparoscopic surgery technique for an
appendectomy. This technique involves making several tiny cuts in the abdomen
and inserting a miniature eye piece and surgical instruments. The surgeon then
removes the appendix with the instruments, thus there is no need to make a large incision in the
abdomen. However, if the appendix is difficult
to remove laparoscopically, or if it has burst, a laparotomy may be necessary.
(A laparotomy involves a large incision into the abdomen.)
People can live a normal life without their appendix. No changes in diet,
exercise, or other lifestyle factors are necessary.
Prevention No prevention of appendicitis is
possible.
Reviewed by Dr Andrew Whitelaw, MBBCh (Witwatersrand), MSc (UCT), FCPath (Micro) (SA) Senior registrar, Department of Microbiology, University of Cape Town and Groote Schuur Hospital.
|
