Appendicitis complications

Written by Ren Zheng Xin
Gastroenterology
Updated on April 22, 2025
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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 Ren Zheng Xin
Gastroenterology
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Causes of appendicitis

The main causes of appendicitis are the narrowing of the appendix lumen and the subsequent blockage of the appendix lumen. Bacterial infection can directly cause acute inflammation. Additionally, poor dietary habits in daily life can also trigger appendicitis. These include overeating and binge drinking, engaging in strenuous exercise right after eating, consuming strong tea, coffee, or spirits, neglecting rest, and excessive fatigue. Therefore, for the prevention of appendicitis, it is mainly important to develop regular lifestyle and eating habits, with meals at fixed times and in measured amounts, and consuming more vegetables to ensure the smooth functioning of the gastrointestinal tract.

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Written by Zhang Peng
General Surgery
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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.

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Written by Ren Zheng Xin
Gastroenterology
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Does appendicitis surgery require an incision?

Appendicitis surgery can be performed through traditional open surgery or minimally invasive treatment. Open surgery involves a traditional incision at McBurney's point to remove the appendix, which is now rarely used, predominantly replaced by minimally invasive treatment under laparoscopy. The procedure is the same for both methods, involving ligation of the appendicular artery followed by cutting the appendix at its base and suturing the stump. The advantages of minimally invasive surgery include less intraoperative bleeding, faster postoperative recovery, and less physical trauma. Patients can choose between open surgery or minimally invasive treatment based on their personal circumstances and financial conditions.

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Written by Ren Zheng Xin
Gastroenterology
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How long does acute appendicitis hurt?

The pain associated with appendicitis is directly related to the severity of the inflammation. If the inflammation is mild, pain can be significantly relieved after using antispasmodic analgesics. However, if acute appendicitis leads to a suppurative appendix or perforation, the abdominal pain will last for a very long time, accompanied by signs of peritoneal irritation, such as tenderness and rebound pain in the abdomen. Therefore, the main principle of treating acute appendicitis is to perform surgery to remove the suppurative appendix. Currently, laparoscopic appendectomy is a viable option, as it involves less bleeding and allows for a faster postoperative recovery.

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

Chronic appendicitis is just a common gastrointestinal disease. Generally, chronic appendicitis does not involve fever. However, a low-grade fever may occur when the inflammation in some cases of chronic appendicitis is not well-controlled. A small percentage of chronic appendicitis can acutely flare up and lead to a purulent infection, causing purulent appendicitis, which may lead to perforation of the appendix, diffuse peritonitis, septic shock, and high fever. Therefore, it is essential to actively treat chronic appendicitis, and early surgical intervention is recommended.