Appendicitis Symptoms
The main symptom of appendicitis is pain that usually starts at a person's navel and then gradually goes to the lower right abdomen. The pain increases over a period of six to 12 hours and becomes severe, leading to possible inflammation and pus infection. It usually affects people between the ages of 10 and 30 and is one of the leading causes of emergency abdominal surgery in children. It can be classified into typical and atypical appendicitis. Acute appendicitis starts at the periumbilical area before localising to the the lower right side of the abdomen. This is followed by a loss of appetite and fever. Nausea that can lead to vomiting may occur. These symptoms are more likely to happen to younger patients while older patients may incur only one or two of these symptoms.
Appendicitis Diagnosis
Diagnosis for acute appendicitis is easier and if required, removal of a swollen appendix can be done with little or no suppuration (pus) if operated within 24 hours from the onset of the ailment. Atypical appendicitis, meanwhile, are more often linked to suppurative appendicitis and begins with lower abdomen pain lingering for several days before it can be diagnosed. This often proves difficult and, if left untreated,removal occurs after the appendix had been ruptured or gangrenous. Tenderness may be present suggesting peritoneal irritation which may require surgical intervention. Learning the patient's medical history and conducting physical examination are done and initial results may show an elevation of neutrophilic white cells on blood testing and imaging, though this is usually not indicative of appendicitis. The classic symptom of appendicitis is usually pain at the periumbilical region which is followed by pain and then tenderness at McBurney's point or the point over the right side of the abdomen that is one third of the distance from the ASIS (anterior superior iliac spine) to the umbillicus.
Other signs of Appendicitis
A patient touching his or her abdominal muscles may often feel these to be rigid due to involuntary spasm. Coughing too produces a localized soreness. A digital rectal exam may also indicate appendicitis since the appendix normally lies on the right. If one inserts a finger into the rectum and feels tenderness once pressure is applied toward the right, the likelihood of appendicitis is strong. Other signs used for diagnosis include the psoas sign for retrocecal appendicitis, the obturator sign for the obturator internus muscle and others. Ultrasonography and Doppler sonography can also be used to detect appendicitis, particularly on children as well as computerized axial tomography (CAT) scans. However CAT scans prove difficult on thin patients and on children who have very little fat in the abdomen. Also due to the high radiation dose, CAT scans are only used when the diagnosis is in doubt. Appendicitis is in most cases a clinical diagnosis.
Treatments for Appendicitis
Appendicitis can be treated through appendidectomy or appendectomy, a surgical removal of the appendix traditionally involving an open laparotomy incision. Though now the operation is often performed via a laparoscopic approach or small incisions with a camera to examine the affected area. If findings reveal complications like rupture, abscess, adhesions, etc., open laparotomy may be necessary. In rare cases the appendicitis is mild or localized to a certain area and thus the body can contain the inflammation and resolve it through time. In this case the affected person may respond to antibiotics treatment alone, at times fed intravenously to help remove the remaining bacteria. This is called "confined appendicitis" and patients improve during several days of observation, thus foregoing the need for surgery. In serious cases wherein an abscess or pus forms along the lining of the abdominal wall drainage may be required to remove the accumulated pus. The appendix is then removed several weeks or months through appendectomy or in this case, interval appendectomy since it is intended to prevent a second attack of appendicitis. Most appendicitis patients recover easily with treatment and recovery time depends on age, condition and complications though it happens within 10 to 20 days. Speedy evaluation and treatment is pursued to avoid complications and emergency appendectomies. That's why prompt diagnosis usually allows for best results with full recovery in two to four weeks usually.
