Appendicitis CT manifestations

Written by Xu Jun Hui
General Surgery
Updated on June 03, 2025
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Appendicitis on a CT scan presents with thickening of the appendix at the ileocecal area, pericecal fluid, high-density shadows in the appendiceal lumen and at its base, and an appendicolith. Clinical manifestations of appendicitis include referred pain in the lower right abdomen, and the examination and form of abdominal pain are important bases for diagnosing appendicitis. Combined with routine blood tests showing high levels of white blood cells and neutrophils, this indicates an inflammatory infection. Diagnosis of appendicitis can be confirmed with an abdominal CT or an ultrasound of the appendix area. Appendicitis is categorized as either acute uncomplicated appendicitis or acute gangrenous appendicitis. Acute uncomplicated appendicitis typically has good treatment outcomes and quick recovery; in contrast, conservative treatment for gangrenous appendicitis is generally less effective, necessitating surgical intervention.

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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.

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Written by Ren Zheng Xin
Gastroenterology
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Does appendicitis surgery hurt?

Appendectomy is performed under either epidural or general anesthesia, so the procedure is completely painless. However, postoperatively, as the anesthesia wears off, there may be slight pain at the incision site. Painkillers can be taken if the pain is intolerable. Additionally, close monitoring of vital signs is important postoperatively. Regular dressing changes at the surgical site and dietary control are required. For the first one to two days after surgery, a semi-liquid diet is recommended. From the third to the fifth day, patients can gradually transition to a normal diet. Furthermore, consuming high-protein foods can enhance nutrition and promote healing of the incision.

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Written by Ren Zheng Xin
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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
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What department should I go to for appendicitis?

Appendicitis is a common disease in general surgery, so one can register for a general surgery appointment. In clinical practice, the diagnosis of appendicitis is mainly based on clinical manifestations. Typical symptoms include abdominal pain, vomiting, and fever. The abdominal pain starts around the navel and then moves to the lower right abdomen after several hours, where the pain becomes localized. Once diagnosed with appendicitis, surgery is often required. Currently, laparoscopic appendectomy is commonly used. This surgical method requires general anesthesia and is relatively complex, but recovery is quicker, and patients typically can be discharged after a routine 3-day hospital stay.

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Can you drink alcohol with appendicitis?

Having appendicitis absolutely prohibits drinking alcohol, as alcohol can stimulate the mucous membranes of the gastrointestinal tract, causing appendicitis to worsen. For appendicitis, active treatment is necessary. During the acute phase, one should not eat anything. In the postoperative recovery or convalescence phase, a semi-liquid or liquid diet can be appropriately chosen. Currently, surgery is the predominant method for treating appendicitis, with laparoscopic appendectomy being a common procedure. This surgical method involves minimal bleeding during the operation and faster postoperative recovery, characterizing it as a minimally invasive treatment. Postoperative care should be enhanced, with increased water intake and more vegetables to prevent constipation.