APPENDICITIS

 Basic information

description

Appendicitis is an inflammation of the appendix. The appendix is a small tube-like pouch that is part of the large intestine. The appendix has no known function, but it can become diseased. Symptoms vary widely. It can affect all ages and both sexes. It occurs most often in ages 10 to 19 and in males more than females.

FREQUENT SIGNS & SYMPTOMS

• Pain that frequently begins close to the navel and moves toward the right lower abdomen. Pain becomes persistent. It worsens with moving, breathing deeply, coughing, sneezing, walking, or being touched.
• Nausea and sometimes vomiting.
• Constipation and inability to pass gas.
• Diarrhea (occasionally).
• Low fever (begins after other symptoms).
• Abdominal swelling (late stages).

causes

The exact cause is unknown. The appendix may be blocked with feces from the intestinal tract which leads to infection. When infected, the appendix becomes swollen, inflamed, and filled with pus.

risk increases with

• Viral or bacterial infection of the gastrointestinal tract.
• Family history of appendicitis.
• Cystic fibrosis.
• Diet that is low in fiber.

PREVENTIVE MEASURES

No specific preventive measures.

expected outcomes

Curable with surgery. People can live a normal life without their appendix.

possible complications

• Rupture of the appendix, abscess (pus-filled area), and peritonitis. Rupture occurs earlier in children, but is more common in older persons.
• Wound infection or other surgery complications.
• Bowel obstruction.

 diagnosis & treatment

general measures

• Don't take any laxatives, enemas, or drugs for pain prior to diagnosis. Laxatives may lead to rupture, and pain or fever reducers make diagnosis more difficult.
• Your health care provider will do a physical exam and ask questions about your symptoms. Medical tests may include blood and urine studies, x-ray, CT, ultrasound, or other tests to confirm the diagnosis.
• Treatment involves surgery to remove the appendix (appendectomy). Because appendicitis can be hard to diagnose, surgery may be delayed until symptoms and signs progress enough to confirm the diagnosis.
• Surgery may be done with a laparoscope (a tube-like instrument with a light on the end). Small incisions (3 to 4) are made in the abdomen. The appendix is removed using instruments inserted into the incisions.
• Open surgery may be done. This involves one larger incision in the abdomen to remove the appendix. This type of surgery is done if the appendix has ruptured (burst).
• If an abscess has formed, surgery may be delayed until the abscess is drained and has time to heal.

medications

• Antibiotics for infection and drugs for pain are usually prescribed after surgery.
• Stool softeners to prevent constipation may be recommended.

activity

• Rest in a bed or chair until surgery.
• Resume normal activities gradually after surgery.

diet

• Don't eat or drink anything until appendicitis has been diagnosed. Anesthesia for surgery is much safer if the stomach is empty. If you are very thirsty, wash your mouth out with water.
• After surgery, a liquid diet is used for a short time. A regular diet may be resumed as the intestinal tract returns to normal.

 notify our office if

• You or a family member has symptoms of appendicitis.
• The following occur after surgery:
  • Fever of 101.5°F (38.6°C) or higher.
  • Increased redness, swelling, or pain at the incision site or if the site has drainage.
  • Vomiting or diarrhea occurs.

Special Notes: