Appendicitis is a condition characterized by inflammation of the appendix. It is classified as a medical emergency and many cases require removal of the inflamed appendix, either by laparotomy or laparoscopy. Untreated, mortality is high, mainly because of the risk of rupture leading to peritonitis and shock.
Appendicitis is a condition in which your appendix becomes inflamed and fills with pus. Your appendix is a finger-shaped pouch that projects out from your colon on the lower right side of your abdomen. This small structure has no known essential purpose, but that doesn't mean it can't cause problems.
Symptoms may include: pain and/or swelling in the abdomen, loss of appetite, nausea and vomiting, constipation or diarrhea, inability to pass gas, and low fever.
Appendectomy can be performed as open surgery using one abdominal incision that's about 2 to 4 inches (5 to 10 centimeters) long. Or appendicitis surgery can be done as a laparoscopic operation, which involves a few small abdominal incisions. During a laparoscopic appendectomy, the surgeon inserts special surgical tools and a video camera into your abdomen to remove your appendix.
Appendicitis is one of the most common causes of emergency abdominal surgery in the United States. It usually occurs when the appendix becomes blocked by feces, a foreign object, or rarely, a tumor.
If your appendix is removed before it ruptures, you will likely get well very soon after surgery. If your appendix ruptures before surgery, you will probably recover more slowly, and are more likely to develop an abscess or other complications.
In Asian and African countries, the incidence of acute appendicitis is probably lower because of the dietary habits of the inhabitants of these geographic areas. The incidence of appendicitis is lower in cultures with a higher intake of dietary fiber. Dietary fiber is thought to decrease the viscosity of feces, decrease bowel transit time, and discourage formation of fecaliths, which predispose individuals to obstructions of the appendiceal lumen.
The appendix is located in the lower right abdomen and is prone to acute and chronic inflammation, known as appendicitis. According to a review article in the November 1999 issue of American Family Physician, the lifetime risk of appendicitis is 7 percent.
The pain begins suddenly and is severe in nature. The pain may begin around the navel and later shifts and settles in the lower right quadrant of the abdomen, also referred to as McBurney's point. The pain increases upon movement, such as coughing or walking, and the affected individual will experience rebound tenderness. Rebound tenderness occurs when pain increases sharply after placing pressure over the lower right portion of the abdomen and quickly removing the pressure. The pain increases in intensity and does not go away without treatment.
When blood flow is reduced, the appendix starts to die. Rupture (or perforation) occurs as holes develop in the walls of the appendix, allowing stool, mucus, and other substances to leak through and get inside the abdomen. An infection inside the abdomen known as peritonitis occurs when the appendix perforates.
Appendicitis may occur after a viral infection in the digestive tract or when the tube connecting the large intestine and appendix is blocked or trapped by stool. Because of the risk of rupture, which may occur as soon as 48 to 72 hours after symptoms begin, appendicitis is considered an emergency and anyone with symptoms needs to see a doctor immediately.
Lymphoid hyperplasia is observed more often among infants and adults and is responsible for the increased incidence of appendicitis in these age groups. Younger children have a higher rate of perforation, with reported rates of 50-85%. The median age at appendectomy is 22 years.