What is this Condition?

Appendicitis is a medical emergency in which the appendix is inflamed due to obstruction and may rupture and spread infection. This is the most common major surgical emergency, affecting men and women equally. Left untreated, appendicitis is fatal, but surgery is an effective cure. Also, the use of antibiotics has helped reduced the number of cases and, thus, the death rate.

What Causes it?

Appendicitis is probably the result of an obstruction in the tube that passes through the appendix from the intestine. This blockage may be caused by a bit of stool, constriction of the tube, or a viral infection. The obstruction causes inflammation, which may lead to infection, a clot, tissue decay, and perforation. If the appendix ruptures or perforates, the infection spills into the abdominal cavity, causing the most common and dangerous complication of appendicitis - peritonitis.

What are its Symptoms?

Symptoms usually occur in the following sequence:

• pain in or around the upper right abdomen

• loss of appetite, nausea, and vomiting

• pain concentrated in the lower right abdomen, with a “boardlike” abdominal rigidity

• increasing tenderness, increasingly severe abdominal spasms and, almost always, soreness to the touch

• lower left side too tender to touch, suggesting the lining of abdomen is inflamed

• constipation (possibly diarrhea), slight fever, and rapid heartbeat

• abdominal pain that ends suddenly (usually means that the appendix has perforated or burst).

How is it Diagnosed?

Your doctor will ask about symptoms, check for tenderness, and look for a mild fever and a moderately high white blood cell count. The physical exam and blood test rule out many illnesses with similar symptoms.

How is it Treated?

Appendectomy, surgery to remove the appendix, is the only effective treatment. Laparoscopic appendectomies, performed through very small incisions, shorten the recovery time.

If the infection has spread and peritonitis develops, the doctor will use antibiotics to fight it and tubes to drain the abdominal cavity.