Appendicitis Health Article

Definition

Appendicitis is an inflammation of the appendix, which is the worm-shaped pouch attached to the cecum, the beginning of the large intestine. The appendix has no known function in the body, but it can become diseased and inflamed. Appendicitis is a medical emergency. If it is left untreated, the appendix may rupture and cause a potentially fatal infection.

Description

Appendicitis is the most common abdominal emergency in children and young adults. One person in 15 develops appendicitis in his or her lifetime. The incidence is highest among males aged 10–14 and females aged 15–19. More males than females develop appendicitis between puberty and age 25. It is rare among the elderly and in children under the age of two.

The hallmark symptom of appendicitis is increasingly severe abdominal pain. The pain of appendicitis begins in the center of the abdomen and becomes concentrated in the lower right quadrant of the abdomen. Since many different conditions can cause abdominal pain, an accurate diagnosis of appendicitis can be difficult. A timely diagnosis is important, however, because a delay can result in perforation, or rupture, of the appendix. When this happens, infected contents of the appendix spill into the abdomen, potentially causing a serious infection of the abdomen called peritonitis.

Other conditions can have similar symptoms, especially in women. These include pelvic inflammatory disease, ruptured ovarian follicles, ruptured ovarian cysts, tubal pregnancies, and endometriosis. Various forms of stomach upset and bowel inflammation may also mimic appendicitis.

The treatment for acute (sudden, severe) appendicitis is an appendectomy, surgery to remove the appendix. Because of the potential for a life-threatening ruptured appendix, persons suspected of having appendicitis are often taken to surgery before the diagnosis is certain.

Causes and symptoms

The causes of appendicitis are not well understood, but it is believed to occur as a result of one or more of these factors: an obstruction within the appendix, the development of an ulceration within the appendix, and the invasion of bacteria.

Under these conditions, bacteria may multiply within the appendix. The appendix may become swollen and filled with pus and may eventually rupture. Signs of rupture include the presence of symptoms for more than 24 hours, a fever, a high white blood cell count, and a fast heart rate. Very rarely, the inflammation and symptoms of appendicitis may disappear but recur again later.

The distinguishing symptom of appendicitis is pain beginning around or above the navel. The pain, which may be severe or only achy and uncomfortable, eventually moves into the right lower corner of the abdomen. There, it becomes more steady and more severe, and often increases with movement or coughing. The abdomen often becomes rigid and tender to the touch. Increasing rigidity and tenderness indicates an increased likelihood of perforation and peritonitis.

Loss of appetite is very common. Nausea and vomiting may occur in about half of the cases, and occasionally there may be constipation or diarrhea. The temperature may be normal or slightly elevated. The presence of a fever may indicate that the appendix has ruptured.