Treatment of Appendicitis

Written by Ren Zheng Xin
Gastroenterology
Updated on July 01, 2025
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For the treatment of appendicitis, generally once diagnosed, surgery is required. Removing the appendix through surgery is the only effective way to prevent the recurrence of appendicitis. Currently, the surgical method most commonly chosen involves removing the appendix via the abdominal cavity, which is also a minimally invasive method. If the patient is older or frail and cannot tolerate general anesthesia, spinal anesthesia can be used to remove the appendix through an incision at McBurney's point. Post-surgery, it is important to change dressings regularly and start a semi-liquid diet after the first passage of gas, gradually transitioning back to a normal diet.

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Written by Ren Zheng Xin
Gastroenterology
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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.

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Written by Li Jin Quan
General Surgery
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Diagnosis methods for chronic appendicitis

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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Written by Si Li Li
Gastroenterology
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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.

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Written by Ren Zheng Xin
Gastroenterology
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How many days of hospitalization are required for appendicitis surgery?

After appendectomy surgery, patients generally need to stay in the hospital for observation for three to five days. If there is no suppuration or infection at the wound, patients can choose to be discharged according to their own wishes. However, if the initial symptoms of appendicitis are severe, or if there is suppuration or perforation, it is advisable to stay in the hospital for additional observation until the abdominal pain subsides before considering discharge. Additionally, elderly individuals or children who are physically weaker should also stay in the hospital for longer observation, as this can aid in recovery.

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Written by Zhang Peng
General Surgery
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Appendicitis belongs to which department?

Appendicitis falls under the domain of general surgery, and its pathological changes can be categorized into several types. The first type is acute simple appendicitis, characterized by mucosal congestion and edema, with patients typically presenting mild symptoms. The second type is acute suppurative appendicitis, also known as cellulitis, where symptoms worsen, and patients may develop fever and experience tenderness and rebound pain in the lower right abdomen. The third type includes acute gangrenous and perforative appendicitis, where the condition further worsens. The appendix wall is necrotic or partially necrotic, and perforation usually occurs at the proximal end of the appendix, potentially leading to the formation of a periappendiceal abscess. If the perforation extends into the abdominal cavity, it can lead to diffuse peritonitis, often requiring emergency surgical exploration. The fourth type involves a periappendiceal abscess, typically progressing slowly. The omentum can move to the lower right side and envelop the appendix, forming adhesions and leading to the formation of an abscess. Most cases are treated conservatively, and traditional Chinese medicine is used adjunctively to promote the absorption of the abscess.