Appendicitis

Appendicitis

Appendicitis can quickly develop into peritonitis: this is an acute abdominal infection causing severe abdominal pains and a very hard abdomen. Peritonitis is a very serious illness. 

Symptoms

Pain

Sudden and severe pain on the right side and the lower abdomen, the localisation of the appendix. The pain radiates down to the leg. It worsens when walking and coughing. 

Appendicitis is an emergency

Contact a doctor urgently or dial 999, or 911 depending on your local emergency number. 

Atypical symptoms

Abdominal pain is not always on the right it can be diffuse and occur on the left because of the atypical position of the appendix. The symptoms of nausea and vomiting for are not always present. 

What to do if faced with possible appendicitis

Do not offer food or drink... Consult urgently a doctor 

A complication of appendicitis is peritonitis

Peritonitis is inflammation of the entire abdominal wall, which encases the stomach, small and large intestine. It is usually an infection that causes peritonitis and the abdomen becomes hard and is diffusely tender. 

Peritonitis is life threatening and needs urgent medical attention. 

A generalised infectious peritonitis begins in general with a pain in a particular point of the abdomen and then diffuses secondarily. 

Symptoms of peritonitis

Pain can start in one area and then diffuses to all over. Rigid hard abdomen when palpated. Vomiting and the bowel stops working completely. 

Emergency hospitalisation

Emergency hospitalisation is necessary for intravenous antibiotics, rehydration and possible surgical intervention. 

Diagnosing appendicitis

Abdominal pain is usually located at the bottom right of the abdomen and is the most usual sign of appendicitis. Pain can also be differed to other areas of the abdomen. A rectal examination, carried out by a doctor, will reawaken this pain. 

Fever, when it is present, is in general around 38°-38°5, but seldom higher. Rapid pulse rate. Other symptoms like fever, constipation, nausea and vomiting for example can be symptoms of other pathology. 

Other examinations

A full blood count. An increase in the number of white cells indicates an infection of some kind.

• Appendicitis can occur despite of a normal blood count
• An increase in white cells can be caused by any type of infection
• A reduction in white cells can also be sometimes a sign of appendicitis
• An increase in CRP, is a sign of inflammation

A X-ray of the abdomen is a very useful examination which helps to exclude other pathologies and to confirm a diagnosis of appendicitis. 

An ultrasound scan is more better at examining soft tissue and can reveal inflammation around the appendix, it can also help differentiate appendicitis from a gynaecological or urinary anomaly. 

Children are always closely monitored and only proceed to surgery if appendicitis is suspected. 

Treatment

Removal of the appendix called appendectomy is essential to treat the problem. Rehydration and antibiotics are also given. 

The main risk is that an appendicitis goes undetected and then develops into peritonitis. 

A doctor should always assess a sudden onset of abdominal pain located on the lower right hand side of the abdomen so that appendicitis can be excluded.