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The appendix is a small, outpouching on the right side of the colon, where it joins the small intestine. The function of the appendix remains a matter of conjecture. This structure is prone to obstruction, inflammation and infection, a condition called appendicitis. Approximately 7 percent of Americans develop appendicitis at some point in their lifetime, reports Dr. Mike Hardin, Jr. in a November 1999 article in "American Family Physician." Appendicitis occurs most commonly between the ages of 10 and 30, and is the leading indication for emergency abdominal surgery.
SIGNS AND SYMPTOMS
Sudden abdominal pain is the hallmark symptom of appendicitis. The pain typically begins around the belly button and migrates to the lower right abdomen. The pain progressively worsens and is aggravated by coughing, moving, sneezing and deep breathing. Drawing the knees toward the chest usually lessens the pain. Other symptoms that may occur with appendicitis include low fever, loss of appetite, nausea, vomiting, bloating and diarrhea or constipation.
DIAGNOSIS
The diagnosis of appendicitis is often made based on the history of the illness and the findings on the physical examination. Blood tests may show an elevation in the white blood cell count. An X-ray, ultrasound or CT scan of the abdomen may be performed if the diagnosis is uncertain. Several medical conditions can mimic the symptoms of appendicitis, including pelvic inflammatory disease, an intestinal blockage, Crohn's disease, ulcerative colitis, a ruptured ovarian cyst, sickle cell crisis, prostatitis, endometriosis and an ectopic pregnancy.
COMPLICATIONS
An infected appendix can rupture in a matter of hours, causing an infection of the abdominal cavity called peritonitis. Peritonitis is a potentially life-threatening infection, which is why the appendix is removed urgently when acute appendicitis is suspected. A sudden spike in fever and worsening pain may indicate rupture of the appendix. If you or a family member develops signs of peritonitis, call 911.
TREATMENT
If your doctor suspects that you have appendicitis, she will likely recommend removal, or an appendectomy. The surgeon may open the abdomen to remove the appendix or perform the operation through an instrument called a laparoscope. In general, laparoscopic surgery involves a shorter recover period compared to an open appendectomy. If your appendix has ruptured, the surgeon will need to clean the abdominal cavity. Intravenous antibiotics are administered to treat the infection. The length of your hospital stay depends on the type of procedure performed and whether your appendix ruptured. Approximately 15 percent of patients operated on for acute appendicitis are found to have a normal appendix, according to the Merck Manual.
References
- American College of Surgeons: Appendectomy
- The Merck Manual Home Health Handbook; Appendicitis; Parswa Ansari, M.D., September 2007
- National Digestive Diseases Information Clearinghouse; Appendicitis; November 2008
- American Family Physician; Acute Appendicitis: Review and Update; D. Mike Hardin, Jr., M.D.; November 1999
