Appendicitis: Causes, Symptoms, Types, Diagnosis, Signs, Treatment and Complications

Appendicitis is the term used to describe an inflammation of the appendix. A finger-shaped pouch that emerges from the colon in the bottom right side of the abdomen, sometimes known as the appendix.

The cause of the pain is appendicitis in the lower right abdomen. However, the majority of patients report that the pain radiates from the belly button. Anybody can have appendicitis, however, people between the ages of 10 and 30 are the most commonly affected. Appendicitis is mostly treated with antibiotics and surgery to remove the appendix.

Causes Of Appendicitis

A blockage in the appendix's lining is most likely the cause of appendicitis. This blockage may lead to an infection. Following that, the bacteria multiply quickly, causing edema, inflammation, and pus buildup in the appendix. 

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Symptoms Of Appendicitis

An appendix may cause the following symptoms:

• The sudden appearance of right-side abdominal pain.
• Sharp pain from the lower right abdomen that frequently extends to the navel.
• Discomfort becomes more severe when coughing, moving, or other sudden motions.
• Nausea 
• Vomiting 
• Decrease in appetite.
• A low-grade fever that might become more severe as the condition progresses.
• Diarrhea and constipation.
• Abdominal bloating.

Depending on the appendix's age and location, the pain may be felt in various locations. With the appendix positioned higher during pregnancy, pain associated with pregnancy may appear to be emanating from the upper abdomen.

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Types Of  Appendicitis

Most of the time, appendicitis is an acute condition, which means that symptoms appear suddenly and worsen quickly. Most of what we know about appendicitis is based on acute instances, which happen often. We are unaware of the rare disease called chronic appendicitis. It occurs when anything irritates your appendix on occasion for a long period, without becoming worse.

Chronic appendicitis may be undetected because its symptoms might not deteriorate as they would in an acute case. All forms of appendicitis, though, are hazardous. If you are unclear about the cause of your recurrent stomach discomfort, see a healthcare provider. Chronic appendicitis episodes might be acute or deteriorating at any time. Healthcare professionals handle it similarly because of this risk.

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Diagnosis Of Appendicitis

If appendicitis is suspected, your doctor's team will likely examine your abdomen and take a history of your symptoms. To identify appendicitis, the tests listed below are used:

• A physical assessment. A medical professional on your team might apply gentle pressure to the painful area. Pain from appendicitis is often exacerbated by a sudden release of pressure. The peritoneum, the membrane lining the abdominal cavity, is inflamed, which is the cause of this.
  • Additionally, when applying pressure to the inflamed appendix, your care team may be watching for any tightness in your abdomen and a tendency to flex your abdominal muscles. This is referred to as guarding. 
  • A member of your medical team may also use a gloved, lubricated finger to examine your lower rectum. This is known as a digital rectal examination. Those who are of reproductive age may get a pelvic exam to check for further problems that could be the cause of their pain.
• Analysis of blood. The purpose of this test is to detect high numbers of white blood cells. A high white blood cell count might be a sign of illness.
• Urine analysis. You may be asked to submit to a urine test, often known as a urinalysis. A urinalysis verifies that neither a kidney stone nor an infection of the urinary system is the source of your discomfort.
• Imaging tests. Imaging tests may also be used to rule out appendicitis or to find other potential causes of your symptoms. Among these might be an abdominal X-ray, an abdominal ultrasound, a CT scan, or an MRI.

How can I test for appendicitis at home?

If you have any suspicions, you should always have a medical expert check for appendicitis. Nonetheless, in case you're looking for a clue, doctors use a couple to check for appendicitis. It might be helpful to know where the discomfort is, especially if it originates at the navel and moves normally to your lower right abdomen. Still, some folks experience pain in various locations. Providers may look for:

• The McBurney sign. McBurney's point is the most typical location for the appendix, and doctors first check for tenderness there while performing a physical examination. By drawing a line from your belly button to your ASIS, a bony projection near your hip, they can determine how far apart you are. The point is two inches, or one-third the distance, along the line.
• Blumberg sign. The feeling that develops after pressure is released from an uncomfortable area is known as rebound tenderness.
• Dunphy's indication. Coughing causes the pain to worsen.
• The indication of roaming. Pressing on your lower left side causes pain on your lower right side.
• Psoas indication. If the psoas muscle lies behind your colon rather than in front, appendicitis might irritate. Sometimes you'll find that if you flex your right hip, the muscle shortens and the pain goes down. Your right hip may be rotated or stretched outward by a medical expert. If it hurts, this is referred to as the Psoas sign. If it hurts to rotate it inward, the obturator signal is shown.

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Treatment Of Appendicitis

Surgery to remove the appendix is the normal course of treatment for appendicitis. Antibiotics may be recommended for the treatment of an infection before surgery.

Surgery to remove the appendix

The removal of the appendix is known as an appendectomy. A single, two to four-inch abdominal incision is all that is needed for an open appendectomy. Laparotomy is the word for this. The surgery may be performed through a few small abdominal incisions. We call this type of procedure laparoscopic. 

During a laparoscopic appendectomy, your appendix is removed through incisions made in your belly by the surgeon using specialized instruments and a video camera. Less discomfort and scarring are common after laparoscopic surgery, as well as a shorter recovery time. For those who are fat and older persons, it could be preferable.

However, not every patient is a suitable candidate for laparoscopic surgery. You may need an open appendectomy if you have an abscess or if the infection caused your appendix to burst and spread outside of it.

Before appendix surgery, an abscess is drained

If an abscess forms around your burst appendix, you might need to have it drained. To empty the abscess, a tube is placed beneath your skin and into the wound. An appendectomy could be performed a few weeks following the infection's resolution.

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Complications Of Appendicitis

Medical practitioners treat appendicitis as an emergency since it can quickly progress into highly grave outcomes. Although they may appear gradually, complications don't usually occur in the same way. Complication phases might include:

• Ischemia and necrosis. Severe appendicitis results in ischemia, or a cutoff of blood flow, which worsens inflammation and ultimately causes necrosis, or the breakdown of tissues.
• Puncture or gangrene. Once necrosis has established itself, infection may spread. If you suffer from internal gangrene (perforation), your ruptured or torn appendix may spread quickly or grow slowly.
• Abscess/phlegmon. It's conceivable that the infection won't go very far past your appendix at first. It might turn into an abscess, which is a pus-filled pocket on the outside of your appendix. Furthermore, the appendix may develop a phlegmon, a lump that encircles it. These lumps contain the infection, yet they have the potential to burst.
• Spreading of the infection and peritonitis. Septicemia is caused by an infection that starts in your peritoneal cavity, travels through your circulation, and eventually affects other organs (peritonitis). A bloodstream infection can cause potentially fatal illnesses including sepsis and septic shock.

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