Appendicitis is an inflammation of the appendix, a small worm-like pouch attached to the large bowel.

Causes of Appendicitis

In most cases, the specific reason for the inflammation is not known but it may be due to blocking of the opening connecting the large intestine and appendix. In many cases it is caused by small pieces of hardened stool (faecaliths) that get stuck in the appendix.

Diagnoses of Appendicitis

  • The doctor takes a medical history from the patient and checks their temperature
  • Blood and urine tests are performed to look for infection
  • The doctor examines the patient by pressing on the lower right part of the abdomen
  • Women are often given a vaginal examination

There is no one test that will diagnose appendicitis with certainty, usually doctors use CT scan or ultrasound to see whether the appendix looks inflamed. Surgery is performed on the basis of the doctor’s examination and results of the tests. Many diseases can cause the same symptoms as appendicitis.

Course of Illness

The inflammation can cause infection, a blood clot, or rupture of the appendix. Because of the risk of rupture, appendicitis is considered an emergency. Anyone with symptoms needs to see a doctor immediately.

Treatment of Appendicitis

  • Surgical removal of the appendix (appendicectomy) is the most common procedure. traditionally a horizontal incision is made in the lower part of the abdomen on the right side, through which the appendix is removed
  • More commonly the appendix is routinely removed by a keyhole operation or laparoscopy. This allows a more rapid recovery with reduced scarring
  • Some case of appendicitis can be safely managed without surgery

Following surgery a two to three day hospital stay is typical. The person can go home when their temperature is normal and their bowel starts to function again. The sutures dissolve and do not need to be removed. A return to ordinary daily life within two to three weeks is usual (Four to six if open surgery has been performed)

Symptoms of Appendicitis

The first sign is usually a pain or discomfort in the centre of the abdomen. The pain usually begins near the umbilicus and moves down and to the right. This pain comes and goes in waves and increases on movement. Pain is often thought at first to be a simple stomach upset.

  • Pain
  • Nausea
  • Vomiting
  • Poor appetite
  • Diarrhoea
  • Low fever that begins after other symptoms
  • Abdominal swelling

Appendicitis can happen at any age but most cases are between 8 and 25 years of age. For young people, appendicitis is probably the most common cause of stomach pain requiring emergency surgery.