Which department should I go to for chronic appendicitis?

Written by Li Jin Quan

General Surgery

Updated on May 08, 2025

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Chronic appendicitis results from the treatment of acute appendicitis, forming a chronic inflammation around the appendix. Clinically, it mainly manifests as recurrent pain or dull pain in the right upper abdomen, with either fecalith obstruction in the appendix cavity or adhesion of the appendix cavity. When chronic appendicitis has an acute flare-up, it is recommended to actively pursue surgical treatment. Therefore, when chronic appendicitis occurs, it is advised to consult general surgery, or gastroenterological surgery if the hospital has specialized departments.

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Written by Li Jin Quan

General Surgery

46sec

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Causes of Chronic Appendicitis

The causes of chronic appendicitis mainly include three aspects. First, the narrowing of the appendiceal lumen. Most cases of chronic appendicitis have a history of acute appendicitis attacks. Long-term recurrent chronic inflammation can lead to thickening of the appendiceal wall, narrowing of the appendiceal lumen, and weakened peristalsis of the appendix. Second, obstruction within the appendiceal lumen by fecaliths is also a common cause of chronic appendicitis. Third, enlarged lymph nodes in the abdominal cavity can compress the appendiceal lumen, causing narrowing and repeated bacterial infections in the appendix. These are the common causes of chronic appendicitis.

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Written by Ren Zheng Xin

Gastroenterology

52sec

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What are the symptoms of appendicitis?

Appendicitis is an acute inflammation occurring in the lumen of the appendix. The primary symptoms include fever, nausea, vomiting, abdominal tenderness, and rebound pain. Migratory right lower abdominal pain is a common indicator used for diagnosing appendicitis. Additionally, appendicitis located posterior to the peritoneum may also present with radiating pain in the lower back. Once appendicitis is diagnosed, surgical treatment is required, except for elderly or frail individuals who cannot tolerate surgery and may opt for conservative treatment. Laparoscopic appendectomy is a commonly used surgical method, as it involves less bleeding during surgery and faster recovery afterwards. Postoperative care should be emphasized, with adjustments in diet, and an increased intake of vegetables to prevent constipation.

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Written by Zhu Dan Hua

Gastroenterology

1min 25sec

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Can appendicitis cause a fever?

Appendicitis can cause fever, and generally, it is considered an inflammatory condition. Besides fever, patients may experience abdominal pain, nausea, vomiting, etc. Typically, the abdominal pain manifests as lower right quadrant pain, which is referred pain. If a patient has fever and typical lower right quadrant pain, further investigations like abdominal ultrasound, complete blood count, and CT scans should be carried out. Diagnosing appendicitis is usually not difficult. The treatment of choice for appendicitis is generally surgical intervention, especially for early-stage patients with symptoms lasting less than three days, where an appendectomy is recommended. However, in some elderly patients with conditions like hypertension, diabetes, etc., who are not suitable for surgery, especially if the duration of the illness is more than three days, conservative medical treatment can be chosen. Conservative treatment primarily involves active anti-infection and anti-inflammatory measures and usually takes longer. (Medication should be administered under the guidance of a doctor.)

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Written by Ren Zheng Xin

Gastroenterology

46sec

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Acute appendicitis pain level

The pain of acute appendicitis is mainly abdominal pain. Currently, there are no available data for reference to understand the level of pain in appendicitis, and the pain associated with acute appendicitis is related to the individual's constitution and the extent of inflammation in the appendix. If the inflammation is mild, limited only to the serosal layer, then the pain is relatively mild and tolerable. If the inflammation is more extensive or involves pus formation, perforation, and affects the peritoneum, it leads to noticeable peritonitis and causes severe, knife-like pain, making the patient scared to move and covered in profuse sweat; the pain is quite severe. For acute appendicitis, surgery is currently advocated as the treatment method.

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Written by Li Jin Quan

General Surgery

47sec

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Where does chronic appendicitis hurt?

Chronic appendicitis, unlike acute appendicitis, does not begin with upper abdominal pain followed by pain in the lower right abdomen, which we refer to as migratory lower right abdominal pain; migratory lower right abdominal pain is a characteristic symptom of acute appendicitis. Chronic appendicitis typically presents with chronic recurrent pain, discomfort, dull pain, or bloating in the lower right abdomen. During a physical examination, chronic appendicitis generally manifests as fixed tenderness in the lower right abdomen, with less evident rebound pain. Rebound pain in the lower right abdomen during a physical exam only occurs when chronic appendicitis acutely flares up and signs of peritonitis are present.