Appendicitis can be a life-threatening
condition that requires immediate medical care.
Appendicitis is a painful
medical condition in which the appendix becomes inflamed and filled with pus, a
fluid made up of dead cells that often results from an infection.
Appendicitis is one of the
leading causes of emergency abdominal operations.
The appendix is a small,
finger-shaped pouch attached to your large intestine on the lower right side of
your abdomen.
It's not entirely clear what
role the appendix plays in the body, but some research suggests that it isn’t
the useless organ it was once thought to be.
Though people can live
perfectly normal lives without their appendix, inflammation of this abdominal
organ can be a serious, life-threatening condition.
If not treated promptly,
appendicitis may cause the appendix to burst, spreading an infection throughout
the abdomen.
When people discuss
appendicitis, they're typically referring to acute appendicitis, which is
marked by a sharp abdominal pain that quickly spreads and worsens over a matter
of hours.
In some cases, however, people
may develop chronic appendicitis, which causes
mild, recurrent abdominal pain that often subsides on its own — these patients
usually don't realize they have appendicitis until an acute episode strikes.
Prevalence and Risk Factors for Appendicitis
Acute appendicitis now affects
about 9 in 10,000 people each year in Africa (roughly 300,000 people annually)
— this prevalence is higher than it was just 20 years ago, according to a 2012
report from the Journal of Surgical Research.
People of any age can get the
condition, though appendicitis is most common among children and teenagers
between 10 and 19 years old, according to the 2012
report.
It affects males more often
than females, but scientists have yet to identify why this is the case.
Appendicitis is more common in
Western societies, and may be more common in urban industrialized areas,
compared with rural communities.
The typical "Western
diet" that's low in fibre and high in carbohydrates is thought to be
behind this pattern.
It also appears that having a
family history of appendicitis increases the risk of getting the condition for
both children and adults.
It is estimated that almost 400
people die in the Africa each year from appendicitis.
Causes of Appendicitis
It's not always clear what causes appendicitis, but the
condition often arises from one of two issues: A gastrointestinal infection
that has spread to the appendix, or an obstruction that blocks the opening of
the appendix.
In the second case, there are
several different sources of blockage. These include:
- Lymph tissue in the
wall of the appendix that has become enlarged
- Hardened stool,
parasites, or growths
- Irritation and
ulcers in the gastrointestinal tract
- Abdominal injury or
trauma
- Foreign objects,
such as pins or bullets
When a person's appendix
becomes infected or obstructed, bacteria inside the organ multiply rapidly.
This bacterial takeover causes the appendix to become infected and swollen with
pus.
Symptoms of Appendicitis
At the onset of appendicitis,
people often feel an aching pain that begins around the belly button, and
slowly creeps over to the lower right abdomen.
The pain sharpens over several
hours, and can spike during movement, deep breaths, coughing, and sneezing.
Other symptoms of appendicitis may follow, including:
- Nausea
- Vomiting
- Constipation or
- Inability to pass
gas
- Loss of appetite
- Abdominal swelling
- Fever
Diagnosing Appendicitis
Because the symptoms of
appendicitis are very similar to other conditions, including Crohn's disease,
urinary tract infections (UTI), gynaecologic disorders, and gastritis,
diagnosing appendicitis is no simple matter.
After learning about a
patient's medical history and recent pattern of symptoms, doctors will use a
number of tests to help them diagnose appendicitis.
They may:
- Conduct an
abdominal exam to assess pain and detect inflammation
- Take a blood test
to determine white blood cell counts, which could indicate an infection
- Order a urine test
to rule out urinary tract infection and kidney stones
- Perform a bimanual
(two-handed) gynecologic exam in women
- Use imaging tests,
including computerized tomography (CT) scans, abdominal X-rays,
ultrasounds, or magnetic resonance imaging (MRI) scans to confirm the
appendicitis diagnosis or find other causes of abdominal pain
Treating Appendicitis
In rare cases, doctors will
treat appendicitis with antibiotics, but the infection needs to be
very mild.
Most often, appendicitis is
considered a medical emergency, and doctors treat the condition with an appendectomy, the surgical removal
of the appendix.
Surgeons will remove the
appendix using one of two methods: open or laparoscopic surgery.
An open appendectomy requires a
single incision in the appendix region (the lower right area of the abdomen).
During laparoscopic surgery, on
the other hand, surgeons feed special surgical tools into several smaller
incisions — this option is believed to have fewer complications and a shorter
recovery time.
If a person's appendix isn't treated
in time, it may burst and spread the infection throughout the abdomen, leading
to a life-threatening condition called peritonitis, an infection of the peritoneum (the lining of the
gut).
In other cases, abscesses may
form on the burst appendix.
In both these cases, surgeons
will usually drain the abdomen or abscess of pus and treat the infection with
antibiotics before removing the appendix.
