Principles of Treatment for Acute Appendicitis

Written by Ren Zheng Xin
Gastroenterology
Updated on May 05, 2025
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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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Written by Jiang Guo Ming
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What should I do if I have appendicitis pain?

Appendicitis should first be diagnosed and treated at the general surgery outpatient clinic. The doctor will perform relevant examinations based on symptoms and signs, such as complete blood count, C-reactive protein, and ultrasound of the lower right abdomen, among others. Based on the results of these tests, the doctor will make an appropriate judgment about the condition. Generally, surgery is advocated for acute appendicitis. If the inflammation is not severe, conservative treatment, primarily focusing on anti-inflammatory treatment, may also be an option. Severe acute appendicitis poses a risk of perforation, and timely hospitalization for surgical treatment is recommended. Chronic appendicitis should also be managed based on specific symptoms, signs, and related examinations, with early surgery performed if possible to prevent recurrent episodes.

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Written by Li Jin Quan
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Causes of Chronic Appendicitis

The causes of chronic appendicitis mainly include three aspects. First, the narrowing of the appendiceal lumen. Most cases of chronic appendicitis have a history of acute appendicitis attacks. Long-term recurrent chronic inflammation can lead to thickening of the appendiceal wall, narrowing of the appendiceal lumen, and weakened peristalsis of the appendix. Second, obstruction within the appendiceal lumen by fecaliths is also a common cause of chronic appendicitis. Third, enlarged lymph nodes in the abdominal cavity can compress the appendiceal lumen, causing narrowing and repeated bacterial infections in the appendix. These are the common causes of chronic appendicitis.

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Written by Ren Zheng Xin
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Acute appendicitis nursing issues

Patients with acute appendicitis should pay attention to diet control during the shivering phase and should refrain from eating or drinking during the attack phase and preoperative preparations. For those with noticeable abdominal pain, a semi-recumbent position should be adopted to reduce muscle tension and alleviate pain. After surgery, it is crucial to closely monitor vital signs, measuring respiration, blood pressure, pulse, etc. On the first day post-surgery, a semi-liquid diet may be chosen, and a normal diet can be resumed on days 3 to 4 post-surgery. It is important to ensure rest, and heavy physical labor should be avoided within two weeks after the surgery.

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Written by Ren Zheng Xin
Gastroenterology
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Acute appendicitis clinical classification

Acute appendicitis can be classified into four types based on the clinical course. The first type is acute simple appendicitis, where the lesions are mostly confined to the mucosa and submucosal layer, with small ulcers and bleeding spots on the mucosal surface. The symptoms and signs are relatively mild. The second type is acute suppurative appendicitis, where the lesion has spread through all the layers of the appendix wall, and pus may accumulate inside, also known as acute cellulitis appendicitis. The third type is gangrenous and perforated appendicitis, which occurs due to pus in the appendix cavity causing increased internal pressure and circulatory disturbances in the appendix wall, leading to mucosal ischemic necrosis and perforation, causing acute diffuse peritonitis. The fourth type is peri-appendiceal abscess, which forms an inflammatory mass encapsulated by the surrounding omentum during suppuration or perforation of acute appendicitis.

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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.