Is This Condition?
is a medical emergency in which the appendix is inflamed due to
obstruction and may rupture and spread infection. This is the most
common major surgical emergency, affecting men and women equally.
Left untreated, appendicitis is fatal, but surgery is an effective
cure. A sudden inflammation of the appendix. The appendix is a narrow,
small, finger-shaped tube that branches off the large intestine.
Appendicitis is probably the result of an obstruction in the appendix.
A bit of stool, constriction, or a viral infection may cause this
blockage. The obstruction causes inflammation, which may lead to
infection, a clot, tissue decay, and perforation. If the appendix
ruptures, the infection spills into the abdominal cavity and causes
peritonitis, the most common and dangerous complication of appendicitis.
is one of the most common causes of emergency abdominal surgery
in children (also in adults). Approximately 4 appendectomies per
1000 children under age 18 are done anually in the United States
(Note: appendicitis is not diagnosed in 100% of appendectomies).
It is more common in males than females and incidence peaks in the
late teens and early twenties. Appendicitis is uncommon under age
two but can occur. Appendicitis generally follows obstruction of
the appendix by feces (fecalith), a foreign body, or tumor.
of appendicitis in young children are seldom classic so diagnosis
is commonly delayed and perforation more likely. Older children
and adolescents have a more typical presentation.
presentation of appendicitis begins with crimpy or "colicky"
pain around the navel (periumbilical). There is usually a marked
loss or total absence of appetite (anorexia). As the inflammation
in the appendix increases the pain tends to move downward and to
the right (right lower quadrant, RLQ) and localizes directly above
the position of the appendix at a point called "McBurney's
Point". (If a line is drawn from the navel to the prominence
on the right pelvic bone (right superior iliac crest) and divided
into thirds, McBurney/s Point is 2/3 away from the navel).
child may be quite tender when the abdomen is pressed at McBurney's
Point. When the abdomen is depressed on the left side, held momentarily,
and then rapidly released the child may experience a momentary increase
in pain (rebound). This finding suggests inflammation has spread
to the peritoneum.
the appendix ruptures the pain may disappear for a short period
and the child feels suddenly better. However, within a short period
peritonitis sets in, the pain returns, and the child becomes progressively
more ill. At this time the abdomen may become rigid and extremely
Does This Present Itself?
Symptoms usually occur in the following sequence:
Is This Condition Diagnosed?
in or around the upper right abdomen highly inaccurate
the pain typically starts in the central abdomen around
the umbilicus then shifts to the lower right abdomen but may
start and remain in right lower abdomen. The pain uncommonly
occur in right upper abdomen.
of appetite, nausea, and vomiting
concentrated in the lower right abdomen, with a board-like abdominal
rigidity (rigidity occurs first in the lower ouadrent and whole
abdomen my become board like when appendix has ruptured.
severe abdominal spasms and soreness to the touch
left side painful to touch, suggesting an inflamed lining of
(possibly diarrhea), slight fever, and rapid heartbeat
pain that ends suddenly (usually means that the appendix has
perforated or burst)
Additional symptoms that may be associated with this disease:
bloody (microscopic hematuria)
lump no "Anal" lump has ever been associated
with appendicitis in the medical history ! A lump can occur
in the right lower abdomen.
Your doctor will ask about symptoms, check for tenderness, and for
a mild fever and a moderately high white blood cell count. The physical
exam and blood test rule out many illnesses with similar symptoms
Is It Managed Conventionally?
Appendectomy, surgery to remove the appendix, is the only effective
treatment. Laparoscopic appendectomies may be performed through
very small incisions. If the infection has spread and peritonitis
develops, antibiotics are used to fight infection and tubes to drain
the abdominal cavity