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Appendicitis – inflammation of the appendix. Because the appendix is so narrow, inflammation can rapidly cause it to swell closed, trapping bacteria laden intestinal matter. This sets the stage for infection that can spread to involve nearby structures.
Appendicitis is an emergency that requires immediate surgery.
Symptoms of Appendicitis
The classic symptoms of appendicitis include
- Pain in the lower right abdomen
- Nausea, vomiting, and aversion to food
- Tendency to lie in somewhat of a fetal position, often on the right side with the knees drawn toward the chest
Appendicitis and Atypical Symptoms
However, more than a third of people who have appendicitis have atypical symptoms that may include diffuse (generalized) abdominal discomfort, pain referred to the back or shoulder area, or symptoms that mimic other health conditions ranging from dyspepsia (indigestion) to urinary tract infection (uti).
Further, there are no definitive causes of appendicitis, though often the surgeon or pathologist detects particles of food or fecal matter lodged in the appendix. The key risk of appendicitis is that the inflamed appendix may perforate (rupture), spilling intestinal debris and infectious matter into the peritoneal cavity. The resulting widespread contamination evolves quickly to peritonitis, a life-threatening infection.
The diagnostic path begins with a physical examination to determine the quality of the pain. Key signs of appendicitis during examination include rebound tenderness (increased pain when the doctor presses slowly downward on the abdomen and then suddenly releases the pressure) and pain (often intense) with pressure applied directly over the location of the appendix.
A digital rectal examination (dre) also often elicits a significant pain response. A complete blood count (CBC) may reveal the inflammatory process or an infection.
Appendicitis Recovery and Risks
Surgical removal of an inflamed appendix (appendectomy) provides the only conclusive diagnosis of appendicitis. Antibiotic medications generally are not effective in treating appendicitis because the infection is generally well under way by the time of diagnosis and the risk of peritonitis or other complicating factors is very high.
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