Appendicitis is an inflammation of the appendix. It’s one of the most common causes of abdominal pain in children and adults. The symptoms are often vague and can be accompanied by other gastrointestinal disorders.   

When you have appendicitis, your doctor may diagnose it based on your symptoms (and sometimes a CT scan), but also on the condition of your appendix. Sometimes doctors will perform an appendectomy — removal of the appendix — to treat appendicitis.

In this article we’ll cover how appendicitis occurs, what causes appendicitis, possible symptoms, and treatment options for appendicitis.

What happens when you have appendicitis?

An inflamed appendix can lead to complications like perforation, which is when part of the appendix ruptures through the wall of the abdomen. It can cause sepsis, which is infection of the blood or body tissues, leading to organ failure. It can also become blocked, causing nausea, vomiting, fever, and weight loss.

Appendicitis can also lead to obstruction of the intestines from fecal matter, which can lead to severe dehydration and electrolyte imbalance.

How appendicitis develops

Appendicitis is caused by an infection within the appendix. Normally, the appendix is about 2-inches long. When there is an infection, the appendix becomes swollen with pus. This swelling and pus can block the small intestine, allowing bacteria that normally live in the colon to move up into the appendix. In rare cases, an abscessed appendix can rupture.

Symptoms of appendicitis

The symptoms of appendicitis depend on whether the appendix has been perforated or not. If it hasn’t been perforated, then the patient will likely experience milder, more gradual symptoms of appendicitis. These include stomach cramps, nausea, vomiting, and diarrhea. Because the appendix is blocked at the top, it doesn’t work well as a pump, so food can back up into the intestines. This leads to pain in the lower right side of the abdomen and some gas. The appendix itself is tender when touched and might feel hard and lumpy, like an eggplant.

If the appendix has ruptured, the patient will likely experience even worse symptoms. They will likely be sicker upon admission, and they will more likely complain of severe pain in the lower right side of their abdomen. Their abdomen will also be distended, they may be experiencing fever, and they may vomit a great deal. Some patients with perforated appendicitis may also experience bloody stools.

In the above paragraph we have told you about some common appendicitis symptoms and if you see it in yourself or your known people then it is necessary to consult with a doctor. If you get any severe pain and the condition goes out from the doctor’s hand then the last option to save you from pain is operation so check it. 

Diagnosing appendicitis

Doctors use several tests to diagnose appendicitis. One is the WBC count, or white blood cell count. A normal WBC count is 4,000-10,000 cells/mm3. Appendicitis is diagnosed when the count is greater than 15,000 cells/mm3. However, the white blood cell count isn’t always reliable. For instance, if a person has an ulcerative colitis flare-up, his or her white blood cell count will go down, even though the person still needs to be treated for appendicitis.

A doctor can also ask the patient about their symptoms, such as where exactly the pain is localized. This helps direct further testing, such as X-rays, CT scans, ultrasounds, etc. Doctors can also do a physical exam, looking for signs of inflammation around the appendix, including guarding (the patient pushing against the examiner) and rigidity (when the examiner presses on the abdomen, the patient feels it more).

Finally, a doctor may order lab tests to rule out other conditions, such as gallbladder disease, Crohn’s disease, diverticulitis, and cancer.

Appendicitis causes

There are three main causes of acute appendicitis:

  Acute bacterial appendicitis:

Bacteria get into the appendix and multiply, creating an infectious environment. The appendix swells and blocks off, leading to perforation, sepsis, and possibly death.

  Perforated appendicitis:

An infected appendix ruptures, releasing its contents into the abdomen and causing bacterial infection.

  Phlegmonous appendicitis:

A phlegmon is an accumulation of purulent fluid beneath the skin.

Other less common causes of appendicitis are neoplasms (cancers) and noninfectious inflammatory bowel disease, although these are generally considered less serious because they usually respond to antibiotics.

Treatment for appendicitis

The treatment of appendicitis depends on the severity of the symptoms, the size of the appendix, and the condition of the appendix. Treatment generally includes:

  Antibiotics:

Antibiotic therapy is the first line of treatment for appendicitis. Most people recover quickly after starting antibiotic treatment.

  Surgery:

Surgical management is recommended for patients whose appendix is either gangrenous (dead tissue) or perforated. There are several different types of surgery available for treating appendicitis, including laparoscopic appendectomy, open appendectomy, and laparoscopic-assisted appendectomy.

Laparoscopic appendectomy

This kind of surgery involves making two incisions in the abdomen, one large enough to place a camera inside and another to access the appendix. During the procedure, the surgeon looks at the appendix with the aid of a telescope, removes any dead tissue, and closes up the opening. Patients typically wake up with minimal discomfort and are able to leave the hospital the same day.

Open appendectomy

During open appendectomy, the surgeon makes a single incision in the abdomen, just under the rib cage. Once he or she reaches the appendix, the surgeon removes any necrotic tissue and closes up the wound.

Laparoscopic-assisted appendectomy

In this type of surgery, a needle is inserted into the abdomen to create a hole for inserting the surgical instruments. Using this method, the surgeon can remove the appendix without having to make a big incision in the abdomen. After the appendix is removed, the incision is closed.