Is appendicitis prone to recurrence?

Written by Ren Zheng Xin
Gastroenterology
Updated on December 17, 2024
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For acute appendicitis, if the appendix is not removed surgically, it is relatively prone to recurrence, and chronic appendicitis may also develop. Therefore, once appendicitis is diagnosed, surgery to remove the appendix is generally required. The more commonly used surgical method is laparoscopic appendectomy. This method involves less bleeding during the surgery and quicker postoperative recovery, with minimal damage to the body. Only small scars can be seen on the body surface, making it a preferable option for those concerned about aesthetics.

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Written by Ren Zheng Xin
Gastroenterology
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Principles of Treatment for Acute Appendicitis

The principle of treatment for acute appendicitis primarily involves surgery. For mild cases or those who cannot tolerate surgery, conservative treatment with medication is also an option. Currently, the choice of surgical method mainly involves laparoscopic appendectomy, which requires general anesthesia. Alternatively, appendectomy can be performed under spinal anesthesia through an incision at McBurney's point. Postoperatively, a pathological examination should be conducted depending on the situation. If there is significant suppuration, anti-inflammatory treatment should be administered post-surgery, with a hospital stay of about three to five days.

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Acute appendicitis pain is on that side.

In the initial stages of acute appendicitis, pain can occur in the left side of the abdomen, then gradually move around the navel, and eventually becomes fixed in the lower right abdomen. The typical symptom of appendicitis is migratory pain in the lower right abdomen, which becomes severe upon pressing and intensifies when lifted, a phenomenon known as rebound tenderness. A small number of patients may experience pain in the lumbar and back areas, which could be due to inflammation caused by a retroperitoneal position. Based on the typical symptoms of appendicitis, a diagnosis cannot be confirmed. After confirmation, most cases require an appendectomy.

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Written by Ren Zheng Xin
Gastroenterology
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How is appendicitis surgery done?

Appendicitis currently primarily involves two surgical methods. One is appendectomy via laparoscopy, and the other is the traditional method involving an incision at McBurney's point to remove the appendix. While the surgical methods differ, the principle behind the surgery is the same: in the abdominal cavity, the appendix is separated from the mesentery, then the appendiceal artery is ligated and the appendix is removed from the base. The stump is disinfected with iodine, and purse-string sutures are used to wrap the stump. If there is an appendiceal perforation causing diffuse peritonitis, it is necessary to thoroughly clean the pus from the abdominal cavity, then check that no surgical instruments are left inside before closing the abdomen. Postoperatively, the use of antibiotic medication depends on the patient's condition, and a minimum rest period of two weeks is required. (The use of medications should be under the guidance of a doctor.)

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Gastroenterology
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Postoperative diet for acute appendicitis

Postoperative diet for acute appendicitis should be taken with special attention. On the day of the surgery, no food should be consumed. After waiting for anal gas to pass, which typically occurs on the first day post-surgery, a semi-liquid diet can be chosen, consisting of easily digestible foods such as rice porridge, millet congee, and vegetable soup. From the third to the fifth day post-surgery, a normal diet can be resumed, including eating eggs and meat to supplement proteins and dietary fibers, which help the incision heal. Vegetables and fruits should also be consumed to prevent constipation. Additionally, proper care should be taken of the incision site, including regular dressing changes.

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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.