A condition in which the appendix becomes inflamed and filled with pus, causing pain.
Symptoms include right lower abdominal wall, nausea, vomiting and decreased appetite. Severe complications of a ruptured appendix include widespread, painful inflammation of the inner lining of the abdominal wall and sepsis.
Appendicitis is caused by blockage of the hollow portion of the appendix. This is the most commonly due to a calcified “stone” made of feces. Inflamed lymphoid tissue from viral infection, parasites, gallstone or tumors may also cause the blockage.
This blockage leads to increased pressures in the appendix, decreased blood flow to the tissue of the appendix and the bacterial growth inside the appendix causing inflammation.
Signs and symptoms Acute appendicitis inside abdominal pain, nausea, vomiting and fever.
As the appendix becomes more swollen and inflamed, it begins to irritate the adjoining abdominal wall. This leads to the localization of the pain to the right lower quadrant.
Signs include localized finding in the right iliac fossa. The abdominal wall becomes very sensitive to gentle pressure (palpation). There is severe pain on sudden release of deep pressure in the lower abdomen.
CAUSES Acute appendicitis seems to be the end result of a primary obstruction of the appendix. Once this obstruction occurs, the appendix becomes filled with mucus and swells. This continued production of mucus leads to increased pressures within the lumen and the walls of the appendix. The increased pressure results in thrombosis and occlusion of the small vessels and stasis of lymphatic flow.
The causative agents include benzoars, foreign bodies, trauma, intestinal worms, lymphadenitis and most commonly, calcified fecal deposits that are known as appendicoliths or fecoliths.
Diagnosis based on a medical history and physical examination which can be supported by an elevation of neutrophilic white blood cells and imaging studies is needed.
Typical appendicitis include several hrs of generalized abdominal pain that begins in the region of the umbilicus with associated anorexia, nausea or vomiting. The pain then “localizes” into the right lower quadrant where the tenderness increase in intensity.
Atypical histories lack this typical progression and ma include pain in the right lower quadrant as an initial symptoms. Irritation of the peritoneum can lead to increased pain on movement and jolting. Atypical histories often require imaging with ultrasound or ct scanning.