What should I do about acute appendicitis?

Written by Ren Zheng Xin
Gastroenterology
Updated on December 02, 2024
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Once acute appendicitis is diagnosed and surgical contraindications are ruled out, appendectomy is usually performed. Currently, the most common method is laparoscopic appendectomy, which results in less intraoperative bleeding and quicker postoperative recovery. After the surgery, depending on the severity of the appendicitis, the use of antibiotics may be considered. Additionally, fasting is required on the day of the surgery, and a semi-liquid diet may be chosen for the first one or two days post-surgery. Three to four days after the surgery, foods like egg custard, vegetable soup, and rice can be eaten, before gradually transitioning back to a normal diet.

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Written by Ren Zheng Xin
Gastroenterology
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How to diagnose appendicitis

Appendicitis is primarily diagnosed clinically through a physical examination. The patient is asked to lie flat, exposing the abdomen, with legs bent. The doctor stands on the patient’s right side and uses the right hand with fingers together to gently rub the abdomen, pressing on the McBurney's point. If there is significant pain, this is considered positive tenderness. Then, the doctor quickly lifts the fingers; if there is significant rebound pain, it is generally confirmed as acute appendicitis. During acute appendicitis, as the appendix lumen expands and the appendix becomes congested and edematous, ultrasound imaging can also show corresponding signs that serve as an auxiliary diagnosis. Once acute appendicitis is confirmed, it is mostly treated surgically.

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Written by Ren Zheng Xin
Gastroenterology
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Does acute appendicitis cause diarrhea?

Acute appendicitis rarely involves diarrhea. Typical symptoms include abdominal pain that begins around the navel or upper abdomen and gradually shifts to the lower right abdomen. The pain is persistent and localized. Additionally, irritation of the gastrointestinal tract may cause nausea or vomiting. If the appendix becomes suppurative or perforated, it can lead to tension in the abdominal muscles, tenderness, and rebound pain. Most cases of acute appendicitis require surgical removal, and currently, laparoscopic appendectomy is a commonly used procedure.

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Written by Li Jin Quan
General Surgery
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Is chronic appendicitis serious?

Chronic appendicitis can achieve good treatment outcomes through active surgical treatment or conservative treatment, and the cases of appendicitis here are not severe. However, a very small portion of patients with chronic appendicitis, especially those with underlying diseases such as diabetes, are at risk of developing a purulent infection of the appendix, which can lead to perforation of the appendix and result in diffuse peritonitis, sepsis, septic shock, and multiple organ failure. Thus, it can be said that there are indeed a few severe cases among patients with chronic appendicitis.

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Written by Ren Zheng Xin
Gastroenterology
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Is there a scar from appendicitis surgery?

Appendectomy involves cutting into the skin, so scars remain on the body after healing. The traditional surgery method through McBurney's point leaves a larger scar, whereas the current laparoscopic treatment, which involves removing the appendix through laparoscopy, only leaves three small incisions on the body and results in smaller scars. Recovery is also faster, making this minimally invasive treatment a preferable option for those who are highly concerned about aesthetics. Additionally, postoperative care is crucial; eating is not allowed on the day of the surgery, a semi-liquid diet is recommended for the first 1-2 days post-operation, and a normal diet can be resumed after 3-4 days.

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Written by Li Jin Quan
General Surgery
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Does chronic appendicitis cause fever?

Chronic appendicitis typically presents clinically as recurring pain and discomfort in the lower right abdomen. Usually, there are no signs of fever with chronic appendicitis. Only when the inflammation of chronic appendicitis is uncontrolled might a low-grade fever occur. Sometimes, when chronic appendicitis undergoes an acute episode and becomes a purulent infection, high fever can occur. In such cases of chronic appendicitis with high fever, complications like appendix perforation, diffuse peritonitis, and septicemia can arise. Therefore, if fever occurs in chronic appendicitis, timely anti-infection treatment should be administered. If the infection is not well-controlled, timely surgical treatment is recommended.