Doctor's Notes on Appendicitis
Appendicitis is inflammation or infection of the appendix, a narrow tubular pouch, about 3 to 4 inches long, extending from the large intestine in the lower right abdomen. Signs and symptoms of appendicitis are usually progressive with vague dull pain beginning in the middle of the abdomen near the naval or bellybutton. Over the next approximate 24-48 hours, abdominal pain may be accompanied with nausea, vomiting, lack of appetite, and/or fever. Pain may progress from dull to sharp. Constipation or diarrhea may develop. The right lower abdomen often becomes painful especially when hand pressure is placed over the appendix. Not all patients with appendicitis will show every symptom or sign. In some individuals, the pain is very intense due to infection and inflammation. The appendix may swell and then rupture with a sharp decrease in pain, but this is a bad sign because it means peritonitis is likely to develop.
When the opening of the appendix is blocked, it is the cause of appendicitis. Causes that can block the opening of the appendix include fecal matter, foreign bodies, inflammation and swelling from viral, bacterial, and/or parasitic infections.
What Is the Treatment for Appendicitis?
Appendicitis is usually treated by antibiotics and surgery to remove the appendix (appendectomy). Antibiotics are given to treat the infected appendix and to help protect against infection spreading to the abdominal cavity. Two types of surgery are usually used:
- Laparotomy is open surgery with one abdominal incision about 2-4 inches to remove the appendix.
- Laparoscopic surgery is performed through small incisions into the abdomen through which surgical tools and a camera is inserted to remove the appendix.
If the appendix bursts, abscess material may be drained through a tube placed in the abdomen and through the skin. There are reports in the literature that, in some people, antibiotics alone may cure appendicitis. Your doctor can help determine which treatments are best for you.
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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.