Diagnosis methods for chronic appendicitis

Written by Li Jin Quan
General Surgery
Updated on November 25, 2024
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The diagnostic methods for chronic appendicitis mainly include medical history, clinical symptoms, physical examination, laboratory tests, and auxiliary examinations. Firstly, cases of chronic appendicitis generally have a history of acute appendicitis episodes. Clinically, it is mainly characterized by pain, discomfort, and dull pain in the lower right abdomen, often without a history of migratory lower right abdominal pain. In physical examinations, tenderness can be found in the lower right abdomen, and when chronic appendicitis flares up acutely, signs of peritonitis can manifest as rebound pain in the lower right abdomen. In laboratory tests, an increased white blood cell count can be observed. Auxiliary examinations may reveal thickening of the appendix wall and obstruction in the appendix lumen due to fecaliths. Therefore, chronic appendicitis can be diagnosed through methods such as medical history, clinical symptoms, physical examination, laboratory tests, and auxiliary examinations.

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Can appendicitis recur?

Acute appendicitis, if not treated surgically, can relapse under poor lifestyle and dietary habits and then transform into chronic appendicitis. Therefore, appendicitis can recur. However, if the appendix is removed during an acute episode of appendicitis, then appendicitis will not recur. Currently, the primary clinical treatment for appendicitis is surgery, because without surgery, the recurrence rate of appendicitis is quite high, and ultimately, the appendix must be removed.

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What department should I go to for appendicitis?

Appendicitis is a very common disease in general surgery, so you can visit the general surgery department at the hospital. The main symptoms of appendicitis are abdominal pain, vomiting, or fever, with the pain being quite severe in acute cases. If the appendix becomes suppurative, it can lead to the formation of a peri-appendicular abscess or appendix perforation, which then causes peritoneal irritation. Active surgical treatment should be pursued, options include traditional removal surgery or laparoscopic appendix removal. Postoperative care should be tailored to the condition of the patient, and rest is essential.

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Does appendicitis cause fever?

Appendicitis often causes fever, due to systemic infection caused by inflammation entering the bloodstream. Generally, it only causes a low fever without chills. The temperature in suppurative appendicitis does not exceed 38 degrees Celsius. High fever above 38 degrees Celsius is mostly seen in cases of appendiceal perforation or concurrent peritonitis. In addition to fever, acute appendicitis also presents with abdominal pain, tenderness and rebound pain in the abdomen, tension in the abdominal muscles, as well as nausea, vomiting, and increased frequency of bowel movements due to reflexive gastric spasms.

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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.

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Which location does appendicitis hurt?

The typical symptom of appendicitis is pain in the lower right abdomen. Generally, during acute appendicitis, the pain can last for several hours or even longer, with about 70% to 80% of patients experiencing characteristic migratory pain in the lower right abdomen. Migratory pain in the lower right abdomen refers to initial pain in the upper abdomen that later manifests as persistent pain in the lower right abdomen. However, some patients initially present with pain in the lower right abdomen directly. In some cases of pregnant women with acute appendicitis, due to the appendix being pushed upward by the enlarged uterus, pain can also occur in the upper right abdomen. Additionally, acute appendicitis is often accompanied by nausea, vomiting, abdominal pain, and diarrhea.