Appendicitis Definition Appendicitis is a condition in which your appendix becomes inflamed and filled with pus.

. Your appendix is a finger-shaped pouch that projects out from your colon on the lower right side of your abdomen. This small structure has no known essential purpose, but that doesn't mean it can't cause problems. The main symptom of appendicitis is pain that typically begins around your na el and then shifts to your lower right abdomen. The pain of appendicitis usually increases o er a period of six to !" hours, and e entually may become ery se ere. Anyone can de elop appendicitis, but it most often strikes people between the ages of !# and $#. The standard treatment for appendicitis is surgical remo al of the appendix. Symptoms Appendicitis can cause a ariety of symptoms that may change o er time%

Early on, the most common symptom is an aching pain around your na el that often shifts later to your lower right abdomen. As the inflammation spreads to nearby tissues, the pain may become sharper and more se ere. Eventually, the pain tends to settle in your lower right abdomen & near your appendix at what's known as 'c(urney point. This point is about halfway between your na el and the top of your right pel ic bone. (ut the location of your pain may ary, depending on your age and the position of your appendix. Young children or pregnant women, especially, may ha e appendicitis pain in different places. What makes pain worse )f you apply gentle pressure to the area that hurts, it will feel tender. As you release the pressure, especially if you do it suddenly, appendicitis pain often will feel worse *rebound tenderness+. )t will also tend to get worse if you cough, walk or make other jarring mo ements. This is particularly true if the inflamed appendix is touching the peritoneum & the silk-like membrane that lines the inner abdominal wall and enfolds the intestines. The pain may lessen somewhat if you lie on your side and pull your knees up toward your chest.

Symptoms other than pain )n addition to pain, you may ha e one or more of the following appendicitis symptoms%

,ausea and sometimes omiting -oss of appetite A low-grade fe er that starts after other symptoms appear .onstipation An inability to pass gas /iarrhea Abdominal swelling Causes The cause of appendicitis is not always clear. 0ometimes it's the result of%

An obstruction. 1ood waste or a hard piece of stool *fecal stone+ can become trapped in an orifice of the ca ity that runs the length of your appendix. An infection. Appendicitis may also follow an infection, such as a gastrointestinal iral infection, or it may result from other types of inflammation. )n both cases, bacteria may subse2uently in ade rapidly, causing the appendix to become inflamed and filled with pus. )f not treated promptly, your appendix is likely to rupture.

When to seek medical advice .hildren are more likely to ha e a ruptured appendix than adults are. .hildren don't always ha e typical symptoms of appendicitis, and parents may delay getting treatment. 1or that reason, it's best not to take abdominal pain lightly. 3 en if you suspect a 4stomachache4 isn't serious, call your doctor just to make sure. 5lder adults also ha e a higher incidence of ruptured appendix, possibly because of delay in seeing a doctor for abdominal pain.

Test and Dia nosis The pain from appendicitis may change o er time, so establishing a diagnosis can sometimes be difficult. )n addition, abdominal pain can arise from a number of health problems other than appendicitis. 5ther conditions with abdominal pain that may resemble that of appendicitis include%

Ectopic pre nancy. An ectopic pregnancy & one that occurs outside the lining of the uterus & can cause similar pain. Certain ovarian cysts. A right-sided o arian cyst may produce pain in the same general area as appendicitis. !idney stone. 5ccasionally, a stone from the right kidney will pass into the ureter, which runs from the kidney to the bladder, and get stuck there. This causes considerable pain that may mimic appendicitis, especially in adults. Crohn"s disease. This condition, which causes chronic inflammation of the digesti e tract, also can mimic appendicitis. #akin a dia nosis To help diagnose appendicitis, your doctor will likely take a history of your signs and symptoms and perform a thorough examination of your abdomen. 6hen gentle pressure on the painful area is suddenly released, appendicitis pain will often feel worse if the adjacent peritoneum is inflamed. 5ther signs your doctor may watch for include abdominal rigidity and a tendency to stiffen your abdominal muscles in response to pressure o er the inflamed appendix *guarding+. )n addition, your doctor may recommend the following procedures%

$lood test. This allows your doctor to check for a high white blood cell count, which may indicate an infection. %rine test. Your doctor may want you to ha e a urinalysis to make sure that a urinary tract infection or a kidney stone isn't causing your pain. )f it is a kidney stone, red blood cells are usually seen during microscopic examination of the urine. &ma in tests. Your doctor may also recommend an abdominal 7-ray or ultrasound scan to help confirm appendicitis or find other causes for your pain. An ultrasound scan uses high-fre2uency sound wa es and computer technology to pro ide images of your internal organs. 'ore commonly, a computeri8ed tomography *.T+ scan is used for confirming a diagnosis. A .T scan is an imaging test that uses a series of computer-generated 7-rays to pro ide a more comprehensi e iew of your internal organs than con entional 7-rays do. )t can also help re eal other potential diagnoses if your appendix is not the source of your pain. (ecause a .T scan produces radiation, women of childbearing age need to ha e a pregnancy test before proceeding with the scan.

Complications The most serious complication of appendicitis is if your appendix ruptures *perforates+ and the contents of your intestines and infectious organisms in ade the abdominal ca ity. This can cause an infection of the lining of the ca ity *peritonitis+.

6hen your appendix ruptures, you may suddenly feel better. (ut soon afterward, your entire abdomen may become distended with gas and fluid and will likely feel tight, hard and tender to the touch. You'll also ha e pain throughout your abdomen, but may not ha e the se ere, locali8ed pain of appendicitis. )n addition, you may not be able to pass gas or ha e a bowel mo ement because of the inflammation. 5ther signs and symptoms may include a fe er, thirst and a low urine output. 9eritonitis is a medical emergency. )f you or a family member de elops signs of this abdominal infection, go to an emergency room immediately. 3 en with prompt treatment, peritonitis can be extremely serious. 0ometimes, infection and the seepage of intestinal contents may form an abscess, a walled-off area of infection *appendiceal abscess+. The abscess may be as small as a walnut or as large as a grapefruit. :egardless of its si8e, it re2uires treatment before the abscess itself perforates, causing peritonitis Treatment and Dru s Appendicitis treatment re2uires surgical remo al of your appendix *appendectomy+ if you ha e acute appendicitis. Your surgeon may perform traditional open surgery, using a single abdominal incision, or laparoscopic surgery, which re2uires only a few small abdominal incisions. )n a laparoscopic procedure, your surgeon inserts a laparoscope & a pencil-thin tube with its own lighting system and miniature ideo camera & into your abdomen through a hollow instrument *cannula+. 5nly a small incision is needed. The ideo camera then produces a magnified iew of the inside of your abdomen on an outside ideo monitor. This allows your surgeon to see the surgery in detail. To remo e your appendix, your surgeon uses tiny instruments inserted through one or two other small abdominal incisions. )n general, laparoscopic surgery allows you to reco er faster and heal with less scarring. (ut if your appendix has ruptured and infection has spread beyond the appendix, or if an abscess is present, you'll need a larger incision so that your surgeon can clean the abdominal ca ity. You'll recei e intra enous antibiotics and will need to stay in the hospital during your reco ery. Dealin with complications )f your symptoms ha e been present for fi e days or more, immediate surgery may present complications. )n this case, your doctor may recommend a course of antibiotics first to try to shrink the inflammation and infection that may be surrounding structures near the appendix. )f an abscess is present, it may be drained through the skin. )f this approach is successful, appendectomy is usually performed a couple of months later. http'((www.mayoclinic.com(health(appendicitis(DS))*+,