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Appendicitis Information on Appendicitis

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User name – Peter Hutch

Appendicitis is an inflammation of the appendix. Once it starts, there is no effective medical therapy, so appendicitis is considered a medical emergency. When treated promptly, most patients recover without difficulty. If treatment is delayed, the appendix can burst, causing infection and even death. Appendicitis is the most common acute surgical emergency of the abdomen. Anyone can get appendicitis, but it occurs most often between the ages of 10 and 30.

The appendix is a closed-ended, narrow tube up to several inches in length that attaches to the cecum (the first part of the colon) like a worm. (The anatomical name for the appendix, vermiform appendix, means worm-like appendage.) The inner lining of the appendix produces a small amount of mucus that flows through the open center of the appendix and into the cecum. The wall of the appendix contains lymphatic tissue that is part of the immune system for making antibodies. Like the rest of the colon, the wall of the appendix also contains a layer of muscle, but the muscle is poorly developed.

Symptoms of acute appendicitis can be classified into two types, typical and atypical.[1] The typical history includes pain starting centrally (periumbilical) before localizing to the right iliac fossa (the lower right side of the abdomen); this is due to the poor localizing (spatial) property of visceral nerves from the mid-gut, followed by the involvement of somatic nerves (parietal peritoneum) as the inflammation progresses. The pain is usually associated with loss of appetite and fever, although the latter isn’t a necessary symptom. Nausea or vomiting may occur. With the typical type, diagnosis is easier to make, surgery occurs earlier and findings are often less severe.

The most exquisitely tender area of the abdomen in the early stage of appendicitis, this point is named after the New York surgeon Charles McBurney (1845-1913), the leading authority in his day on appendicitis. In 1889, McBurney showed that incipient appendicitis could be detected by applying pressure to a particular spot in the right lower abdomen, a point he called the “seat of greatest pain,” which corresponds to the normal location of the base of the appendix.

The surgeon’s goals are to evaluate a relatively small population of patients referred for suspected appendicitis and to minimize the negative appendectomy rate without increasing the incidence of perforation. The emergency physician must evaluate the larger group of patients who present to the ED with abdominal pain of all etiologies with the goal of approaching 100% sensitivity for the diagnosis in a time-, cost-, and consultation-efficient manner.

The appendix is a small, tube-like organ attached to the first part of the large intestine, also called the colon. It is located in the lower right area of the abdomen. It has no known function. A blockage inside of the appendix causes appendicitis. The blockage leads to increased pressure, problems with blood flow and inflammation. If the blockage is not treated, the appendix can break open and leak infection into the body.

Appendicitis is treated by removing the inflamed appendix through an appendectomy. Surgeons usually remove a child’s appendix either by making a traditional incision in the abdomen, or by using a small surgical device called a laparoscope that creates a smaller opening in the abdomen. An appendectomy usually requires a 2- to 3-day hospital stay.

The appendix is a narrow tubular pouch that is attached to the intestines. When the appendix is blocked, it becomes inflamed and results in the condition known as appendicitis. If the blockage continues, the inflamed tissue becomes infected with bacteria and begins to die from a lack of blood supply, which finally results in the appendix bursting.

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