Appendicitis Health Article

Definition

Appendicitis is inflammation of the appendix. The appendix is a small pouch attached to your large intestine.

Causes, incidence, and risk factors

Appendicitis is one of the most common causes of emergency abdominal surgery in the United States. Appendicitis usually occurs when the appendix becomes blocked by feces, a foreign object, or rarely, a tumor.

Symptoms

The symptoms of appendicitis vary. It can be hard to diagnose appendicitis in young children, the elderly, and women of childbearing age.

Typically, the first symptom is pain around your belly button. (See: abdominal pain.) The pain may be vague at first, but becomes increasingly sharp and severe. You may have reduced appetite, nausea, vomiting, and a low-grade fever.

As the inflammation in the appendix increases, the pain tends to move into your right lower abdomen and focuses directly above the appendix at a place called McBurney's point.

If the appendix ruptures, the pain may lessen briefly and you may feel better. However, once the lining of the abdominal cavity becomes inflammed and infected (a condition called peritonitis), the pain worsens and you become sicker.

Abdominal pain may be worse when walking or coughing. You may prefer to lie still because sudden movement causes pain.

Later symptoms include:

• Chills
• Constipation
• Diarrhea
• Fever
• Loss of appetite
• Nausea
• Shaking
• Vomiting

Signs and tests

If you have appendicitis, your pain increases when the doctor suddenly releases the pressure after gently pressing on your lower right belly area. If peritonitis is present, touching the belly area may cause a spasm of the muscles.

A rectal examination may reveal abdominal or pelvic tenderness on the right side of your body.

Doctors can usually diagnose appendicitis by your description of the symptoms, the physical exam, and laboratory tests alone. In some cases, additional tests may be needed. These may include:

• Abdominal CT scan
• Abdominal ultrasound
• Diagnostic laparoscopy

Note: The U.S. Food and Drug Administration recalled a drug used during some appendicitis-related imaging tests after reports of life-threatening side effects and deaths. The drug, called NeutroSpec, was used to help diagnose appendicitis in patients ages 5 and older who may have had the condition but did not show the usual signs and symptoms.