Appendicitis

Appendicitis is an inflammation of the appendix. The appendix is a worm-shaped appendage, averaging 9 cm in length, located at the end of your cecum. Symptoms that may indicate acute appendicitis include:

• ‍severe pain in the lower right part of your abdomen;
• Pain when tapping, pressing, and releasing the sensitive area.

Appendicitis is often referred to as “inflammation of the appendix,” but in cases of appendicitis, it is not the entire appendix that is inflamed. The appendix is the blind (closed) end of your large intestine. It is located in the lower right part of your abdomen, at the junction between your small and large intestines.

Stomachache

• You usually experience pain in your lower right abdomen that quickly gets worse. That is the typical symptom of appendicitis.
• You may also first feel severe pain around your navel. After a few hours or days, this pain moves to the lower right side.
• You may experience pain in a different location. This is because the exact location of the appendix varies from person to person.

Other complaints

• You may experience a loss of appetite, nausea, and vomiting.
• You have a fever and are feeling unwell.
• Driving on a bumpy road hurts. Coughing, walking, and jumping are also painful.

Appendicitis is often caused by a narrowing or blockage of the appendix, usually due to a piece of hardened stool.

Interview and Physical Examination

Your doctor usually suspects appendicitis based on the typical symptoms and signs observed during a physical exam.

• Your lower right abdomen is tender.
• Your abdominal muscles are tense (muscle resistance). Your abdomen becomes hard in the sensitive area.
• Pulling your stomach in and letting go again hurts.

Blood Test

In addition, your doctor will draw blood to check for inflammation and determine your white blood cell count.

Imaging Studies

If your doctor is unsure about the correct diagnosis, he or she will also order an ultrasound or CT scan. Based on these tests, the doctor will determine whether you have appendicitis or something else. Many conditions can cause acute abdominal pain, especially in women (e.g., intestinal infection, urinary tract infection, kidney stones, gynecological infections, ectopic pregnancy, etc.).

Keyhole surgery

If the diagnosis is still unclear after imaging tests, exploratory surgery may be necessary. The doctor can then remove your appendix immediately if it is inflamed.

Remove the Appendix

To treat appendicitis, a surgeon usually has to remove the appendix through surgery (appendectomy). Nowadays, this is usually done through laparoscopic surgery: through three small incisions, the surgeon can view and remove your appendix. This surgery is performed under general anesthesia. At the same time, you’ll be given antibiotics through an IV.

Antibiotic Treatment

• In cases of early-stage appendicitis with mild symptoms, antibiotics alone may sometimes be sufficient as treatment.
• If your peritoneum is inflamed, you must undergo peritoneal lavage as soon as possible. This is done through surgery: a surgeon flushes your abdominal cavity with lukewarm saline to remove all the pus. You will be given antibiotics through an IV.
• If you have an abscess, you will first be given antibiotics to treat the bacteria typically found in the abscess. Later, a surgeon may remove your appendix.