All about Acute Appendicitis

Endocrinology and Paediatric Endocrinology

The appendix is a small, tube-shaped organ that is attached to the large intestine. Acute appendicitis is when someone's appendix gets very sore and has pain in the lower-right side of their stomach. It can happen quickly. The appendix might need to be taken out, so it does not hurt anymore. Antibiotics will be given, and surgery needs to happen within a day or two of the diagnosis.

The main causes for acute appendicitis are Infection or parasites, or foreign bodies like seeds getting attached to an appendix, increase in gas pressure inside the abdomen (usually secondary to constipation), pregnancy in women over 30 years old, abnormal anatomy (a congenital abnormality).

Symptoms of Acute Appendicitis:

The symptoms of acute Appendicitis in adults can include:

  • Sudden pain around the belly button
  • Sudden central abdominal pain migrating to the lower right abdominal region
  • Intensified pain during first 24 hours
  • Nausea and vomiting
  • Abdominal bloating, swelling and flatulence
  • Diarrhea or constipation
  • Loss of appetite
  • Low-grade fever

Children will usually show symptoms like these:

  • Pain in the lower right abdominal region
  • Low-grade fever
  • Loss of appetite
  • Nausea and vomiting

Causes of Acute Appendicitis:

The main causes of acute appendicitis are an infection, a parasite, or a foreign object like a seed that attaches to the appendix. Sometimes constipation can cause gas pressure in the abdomen and lead to appendicitis. Women who are over 30 years old and pregnant sometimes get this disease. If someone has had surgery on their appendix before they might be more at risk for it happening again because of abnormal anatomy. Doctors think that when bacteria block up the area where the food and waste go through and there is inflammation and infection it will happen.

  • Viral/bacterial/parasitic infections
  • Enlarged lymphoid follicles
  • Hardened stool build-up
  • Traumatic injuries
  • Tumors
  • Intestinal worms

Diagnosis of Acute Appendicitis

In some cases, people cannot get an ultrasound. They can do a blood test. If you have appendicitis then the doctor will ask you questions and then give you a series of tests. These tests might include an ultrasound or blood test.

Physical examination:

Your doctor will put pressure on your stomach. If you have swelling, tenderness or if the stomach is hard it means that something is wrong.

Blood test:

A blood sample is taken to assess the complete blood count. This helps doctors diagnose problems with your body.

Urine test:

When someone has pain, they do a urine analysis. This helps to figure out what is wrong with their body.

Imaging tests:

Doctors can do an imaging scan to check for other causes of your pain. This might be an abdominal X-ray, MRI, CT scan, or ultrasound.

Complications of Acute Appendicitis

Complications can happen during surgery. The doctor will have to fix the problem before it becomes worse. If something goes wrong, it could lead to an infection or fluid leaking into the abdomen, which is not good for your body. It could also cause you to have shock, which is when your whole system slows down because of these problems that are happening in your body. If there are other problems that happen outside of the area near the appendix, they might be infections too and will need treatment with medicine.

Treatment for Acute Appendicitis

Usually, if you get appendicitis, doctors will use antibiotics and surgery to make it better. If you have pus in your stomach (peritonitis), then they might need to do surgery right away. These surgeries usually involve removing the appendix. There are two types of these surgeries:

Open surgery:

The surgery is done with a cut that is about 4-5 inches long in the lower right side of your belly.


The surgery is done with small incisions and a video camera. It removes your appendix.

Although laparoscopy can make it easier to heal and recover from surgery, it is not the best option for everyone. If you have had appendicitis and the infection has spread beyond your appendix, then open surgery may be a better option. Recovery from this will take about 1-2 days.


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