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Appendicitis
Appendicitis complications
Appendicitis is the inflammation of the appendix lumen. If not treated promptly, it can lead to several complications, such as perforation of the appendix. After perforation, pus from the appendix lumen leaks into the abdominal cavity, causing peritonitis, which leads to abdominal pain, tenderness, and rebound pain. Furthermore, if acute appendicitis is not thoroughly treated, it can progress to chronic appendicitis and periappendiceal abscess. A swollen mass can often be felt on the surface of the abdomen in affected patients. Therefore, active treatment for appendicitis is essential. The principle treatment is surgical removal of the appendix. For mild cases of appendicitis, medical conservative observation and treatment can also be chosen.
Where does appendicitis hurt?
In general clinical practice, the pain associated with appendicitis mostly occurs in the lower right abdomen. Some patients experience very typical migratory right lower abdominal pain which usually starts in the upper abdomen, gradually moves around the navel, and finally localizes in the lower right abdomen. Direct pain in the lower right abdomen could also be indicative of appendicitis. In rare cases, if there is a reversal of organs or an abnormal position of the appendix, pain may occur in the upper right abdomen or lower abdomen as well. For pregnant women, the appendix may be positioned higher and could cause pain under the rib cage. Therefore, the diagnosis of appendicitis should be based on the specific condition of the patient and related diagnostic tests.
What tests are done for appendicitis?
Appendicitis examination primarily involves a physical examination. The patient lies flat with their legs bent, and the doctor stands on the patient's right side. The patient exposes their abdomen, and the doctor places their right palm flat in the middle of the abdomen, then smoothly performs a clockwise palpation, pressing the abdomen to check for rebound tenderness, especially at McBurney's point. If there is significant tenderness and rebound pain at McBurney's point, along with symptoms of fever and nausea, appendicitis is generally considered. An ultrasound can also be used as an auxiliary examination, where swelling of the appendix can be observed. Based on the physical examination and auxiliary tests, a preliminary diagnosis of appendicitis can be made.
Does chronic appendicitis cause fever?
Chronic appendicitis is a common gastrointestinal disease. Whether chronic appendicitis causes fever depends on the control of the inflammation. Most cases of chronic appendicitis do not involve fever, but some cases may exhibit a low fever when the inflammation is not well controlled. A very small percentage of chronic appendicitis cases can undergo acute episodes and develop suppurative infections, leading to perforation of the appendix and diffuse peritonitis, septicemia, and septic shock; in such acute episodes of chronic appendicitis, a high fever can occur.
Appendicitis surgery how many days to remove stitches?
Appendectomy stitches are generally removed about a week after the surgery. However, there are special circumstances where the removal of stitches may be delayed. For example, if the patient is physically weak, nutritionally compromised, or if the wound heals slowly, it is necessary to wait until the wound has sufficiently healed before removing the stitches. If the appendectomy incision shows clear signs of pus formation, it is crucial to remove the stitches promptly, thoroughly clean the wound, and then dress it externally. Therefore, the timing for stitch removal after an appendectomy should be based on the patient's current medical condition.
Can you drink alcohol with appendicitis?
Having appendicitis absolutely prohibits drinking alcohol, as alcohol can stimulate the mucous membranes of the gastrointestinal tract, causing appendicitis to worsen. For appendicitis, active treatment is necessary. During the acute phase, one should not eat anything. In the postoperative recovery or convalescence phase, a semi-liquid or liquid diet can be appropriately chosen. Currently, surgery is the predominant method for treating appendicitis, with laparoscopic appendectomy being a common procedure. This surgical method involves minimal bleeding during the operation and faster postoperative recovery, characterizing it as a minimally invasive treatment. Postoperative care should be enhanced, with increased water intake and more vegetables to prevent constipation.
Is surgery necessary for appendicitis?
Once appendicitis is diagnosed, most cases require surgical treatment because the blood supply to the appendix is quite unique, with only the appendicular artery providing blood flow. If appendicitis occurs, it can easily lead to ischemic necrosis of the appendix, resulting in gangrenous appendicitis. Currently, laparoscopic appendectomy is a common surgical procedure, which is a minimally invasive treatment. For elderly or frail individuals who cannot tolerate surgery, conservative treatment is the only option. Postoperative care should be enhanced, with regular dressing changes at the incision site, and stitches can generally be removed one week after surgery. A semi-liquid diet is recommended for one to two days after surgery, and a regular diet can be resumed three to four days post-operation.
What should I do if I have appendicitis pain?
Appendicitis should first be diagnosed and treated at the general surgery outpatient clinic. The doctor will perform relevant examinations based on symptoms and signs, such as complete blood count, C-reactive protein, and ultrasound of the lower right abdomen, among others. Based on the results of these tests, the doctor will make an appropriate judgment about the condition. Generally, surgery is advocated for acute appendicitis. If the inflammation is not severe, conservative treatment, primarily focusing on anti-inflammatory treatment, may also be an option. Severe acute appendicitis poses a risk of perforation, and timely hospitalization for surgical treatment is recommended. Chronic appendicitis should also be managed based on specific symptoms, signs, and related examinations, with early surgery performed if possible to prevent recurrent episodes.
Appendicitis McBurney's point location
McBurney's point is a point of tenderness on the body surface during an episode of appendicitis, located on the right side of the abdomen, specifically at the outer third of the line connecting the navel to the right anterior superior iliac spine. If the appendix is significantly swollen or suppurative, there will be intense tenderness and rebound pain at McBurney's point. The tenderness and rebound pain at McBurney's point are also important physical examination signs for the clinical diagnosis of appendicitis. Based on the tenderness at McBurney's point, a preliminary diagnosis of appendicitis can be made, and then, the state of appendiceal swelling can be examined by abdominal ultrasound to choose a systematic treatment based on the results.
How long to rest after appendicitis surgery?
After an appendectomy, if there is no significant suppuration or infection, a recovery period of at least two weeks is required. During this period, it is important to rest, pay attention to diet, increase nutrition, and increase protein intake, such as eating more chicken, fish, and soy products. Also, consume more vegetables and fruits, engage in appropriate exercises to increase gastrointestinal motility. The surgical incision should be dressed regularly, and sutures can be removed after a week post-operation, then depending on the condition, decide whether to change the dressing again.