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Appendicitis
Appendicitis is swelling (inflammation) of the appendix. The appendix is a small pouch attached to the large intestine.
Causes
Appendicitis is a very common cause of emergency surgery. The problem most often occurs when the appendix becomes blocked by feces, a foreign object, or rarely, a tumor .
Tumor
A tumor is an abnormal growth of body tissue. Tumors can be cancerous (malignant) or noncancerous (benign).
Symptoms
The symptoms of appendicitis can vary. It can be hard to diagnose appendicitis in young children, the elderly, and women of childbearing age.
The first symptom is often pain around the belly button. Pain may be minor at first, but becomes more sharp and severe. You may also have a loss of appetite, nausea, vomiting, and a low fever.
The pain tends to move into the right lower part of your belly. The pain tends to focus at a spot directly above the appendix called McBurney's point . This most often occurs 12 to 24 hours after the illness starts.
McBurney's point
Abdominal point tenderness is the pain you feel when pressure is placed over a certain part of the belly area (abdomen).
If your appendix breaks open (ruptures), you may have less pain for a short time and you may feel better. However, the pain soon gets worse and you will feel sicker.
Your pain may be worse when you walk, cough, or make sudden movements. Later symptoms include:
- Chills and shaking
- Hard stools
- Diarrhea
- Fever
- Nausea and vomiting
Exams and Tests
How you describe your symptoms can lead your health care provider to suspect appendicitis.
Your provider will do a physical exam.
- If you have appendicitis, your pain will increase when your lower right belly area is pressed.
- If your appendix has ruptured, touching the belly area may cause a lot of pain and lead you to tighten your muscles.
- A rectal exam may find tenderness on the right side of your rectum.
A blood test will often show a high white blood cell count. Imaging tests may also help diagnose appendicitis. Imaging tests include:
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CT scan of the abdomen
CT scan of the abdomen
An abdominal CT scan is an imaging method. This test uses x-rays to create cross-sectional pictures of the belly area. CT stands for computed tomog...
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Ultrasound of the abdomen
Ultrasound of the abdomen
Abdominal ultrasound is a type of imaging test. It is used to look at organs in the abdomen, including the liver, gallbladder, spleen, pancreas, and...
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Treatment
Most of the time, a surgeon will remove your appendix as soon as you are diagnosed.
Remove your appendix
An appendectomy is surgery to remove the appendix.
If a CT scan shows that you have an abscess , you may be treated with antibiotics first. You will have your appendix removed after the infection and swelling have gone away.
Abscess
An abscess is a collection of pus in any part of the body. In most cases, the area around an abscess is swollen and inflamed.
The tests used to diagnose appendicitis are not perfect. As a result, the operation may show that your appendix is normal. In that case, the surgeon will remove your appendix and explore the rest of your abdomen for other causes of your pain.
Outlook (Prognosis)
Most people recover quickly after surgery if the appendix is removed before it ruptures.
If your appendix ruptures before surgery, recovery may take longer. You are also more likely to develop or problems, such as:
- An abscess
- Blockage of the intestine
- Infection inside the abdomen (peritonitis)
- Infection of the wound after surgery
When to Contact a Medical Professional
Call your provider if you have abdominal pain in the lower-right portion of your belly, or other symptoms of appendicitis.
Abdominal pain
Abdominal pain is pain that you feel anywhere between your chest and groin. This is often referred to as the stomach region or belly.
References
Bundy DG, Byerley JS, Liles EA, Perrin EM, Katznelson J, Rice HE. Does this child have appendicitis? JAMA . 2007;298:438-451. PMID: 17652298 www.ncbi.nlm.nih.gov/pubmed/17652298 .
Sifri CD, Madoff LC. Appendicitis. In: Bennett E, Dolin R, Blaser MJ, eds. Mandell, Douglass, and Bennett's Principles and Practice of Infectious Diseases . 8th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2014:chap 80.
Smith MP, Katz DS, Lalani T, et al. ACR Appropriateness Criteria® Right Lower Quadrant Pain-Suspected Appendicitis. Ultrasound Q . 2015;31:85-91. PMID: 25364964 www.ncbi.nlm.nih.gov/pubmed/25364964 .
Wolfe JM, Henneman PL. Acute appendicitis. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier Mosby; 2014:chap 93.
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Anatomical landmarks, front view - illustration
There are three body views (front, back and side) that may be helpful if you are uncertain of a body area. Many areas are referred to by both descriptive and technical names. For example, the back of the knee is called the popliteal fossa. However, areas like the "flank" may not have both names, so the location may be unclear.
Anatomical landmarks, front view
illustration
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Digestive system - illustration
The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.
Digestive system
illustration
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Appendectomy - Series
Presentation
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Appendicitis - illustration
The appendix is a small finger-shaped tube that branches off the first part of the large intestine. The appendix can become inflamed or infected causing pain in the lower right part of the abdomen.
Appendicitis
illustration
-
Anatomical landmarks, front view - illustration
There are three body views (front, back and side) that may be helpful if you are uncertain of a body area. Many areas are referred to by both descriptive and technical names. For example, the back of the knee is called the popliteal fossa. However, areas like the "flank" may not have both names, so the location may be unclear.
Anatomical landmarks, front view
illustration
-
Digestive system - illustration
The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.
Digestive system
illustration
-
Appendectomy - Series
Presentation
-
Appendicitis - illustration
The appendix is a small finger-shaped tube that branches off the first part of the large intestine. The appendix can become inflamed or infected causing pain in the lower right part of the abdomen.
Appendicitis
illustration
Review Date: 4/20/2015
Reviewed By: Subodh K. Lal, MD, gastroenterologist at Gastrointestinal Specialists of Georgia, Austell, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
