Appendicitis is a condition in which the appendix becomes inflamed and filled with pus, experienced by about 7 percent of Americans.
The appendix is a small, finger-shaped pouch that projects out from your colon on the right-hand side. The appendix has no known purpose, but that doesn’t mean it can’t cause problems.
The main symptom is pain that begins around the navel and then shifts to the lower-right abdomen. The pain usually increases over a period of 12 to 24 hours, and eventually may be very severe.
An appendicitis does not discriminate, anyone can develop it , but it most often strikes people between the ages of 10 and 30 and is one of the most common reasons for emergency abdominal surgery in children.
The standard treatment for appendicitis is surgical removal of the appendix (appendectomy). In many cases the surgery is straightforward and you recover quickly. But if your appendix has ruptured, the surgery may be more complicated and you’ll take longer to heal. A ruptured appendix that’s not promptly treated can lead to serious complications such as an infection of the abdominal lining (peritonitis) or a walled-off area of infection (an abscess). In rare instances a ruptured appendix may be fatal.
Signs and Symptoms
Appendicitis can cause a variety of symptoms that may change over time. The most obvious early symptom is an aching pain around your navel that often shifts to your lower-right abdomen. As the inflammation in your appendix spreads to nearby tissues, the pain may become sharper and more severe.
Eventually the pain tends to settle in your lower-right abdomen just above your appendix at what’s known as McBurney’s point. This point is about halfway between your navel and your right pelvic bone. But the location of your pain may vary, depending on your age and the position of your appendix. Young children, especially, may have appendicitis pain in different places.
If you apply gentle pressure to the area that hurts, it will feel tender. As you release the pressure, the pain often will feel worse (rebound tenderness). It will also tend to get worse if you cough, walk or make other jarring movements. The pain may lessen somewhat if you lie on your side and pull your legs up beneath you.
In addition to pain, you may have one or more of the following symptoms:
- Nausea and sometimes vomiting
- Loss of appetite
- A low-grade fever that starts after other symptoms appear
Causes
It’s not always clear why this condition occurs. Sometimes it’s the result of an obstruction when food waste or a hard piece of stool (fecal stone) becomes trapped in the cavity that runs the length of your appendix.
Appendicitis may also follow an infection, especially a gastrointestinal viral infection, or it may result from other types of inflammation. In both cases, bacteria may subsequently grow rapidly, causing the appendix to become inflamed and filled with pus. If not treated promptly, your appendix eventually may rupture.
Treatment
If you have an acute condition, you’ll need to have your appendix surgically removed (appendectomy). Your surgeon may perform traditional open surgery, using a single long abdominal incision, or choose laparoscopic surgery, which requires only a few small abdominal incisions.
In a laparoscopic procedure, your surgeon inserts a laparoscope a pencil-thin tube with its own lighting system and miniature video camera into your abdomen through a hollow instrument (cannula). Only a small incision is required. The video camera then produces a magnified view of the inside of your abdomen on an outside video monitor. This allows your surgeon to see the surgery in detail. To remove your appendix, your surgeon uses tiny instruments inserted through several other small abdominal incisions.
In general, laparoscopic surgery will allow you to recover faster and heal with less scarring. But 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 and will need to stay in the hospital during your recovery.
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