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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Which department should I go to for chronic appendicitis?

Chronic appendicitis results from the treatment of acute appendicitis, forming a chronic inflammation around the appendix. Clinically, it mainly manifests as recurrent pain or dull pain in the right upper abdomen, with either fecalith obstruction in the appendix cavity or adhesion of the appendix cavity. When chronic appendicitis has an acute flare-up, it is recommended to actively pursue surgical treatment. Therefore, when chronic appendicitis occurs, it is advised to consult general surgery, or gastroenterological surgery if the hospital has specialized departments.

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Written by Ma Xian Shi
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Early symptoms of appendicitis

What are the initial symptoms of appendicitis? It is characterized by abdominal pain. The main symptom is abdominal pain that appears around the upper abdomen or navel, and some patients may also experience nausea and vomiting. Generally, two to three hours later, the abdominal pain gradually shifts to the lower right abdomen, which we clinically refer to as migratory right lower abdominal pain. This symptom accounts for about 80% of clinical cases, while some patients present directly with pain in the lower right abdomen, without transitional abdominal pain. Therefore, the primary symptom of appendicitis is abdominal pain, as described in these two scenarios. However, physical examination is also very important, typically revealing localized fixed tenderness in the lower right abdomen as the main clinical manifestation.

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Written by Ren Zheng Xin
Gastroenterology
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Will there be a scar from appendicitis surgery?

Appendectomy can leave scars, especially more noticeable in people prone to scarring. Currently, there is a minimally invasive treatment that involves the removal of the appendix under laparoscopy. This method only requires three small incisions on the abdomen, resulting in smaller scars and a faster postoperative recovery. The traditional method, which involves making an incision at McBurney's point, leaves a slightly larger scar and has a slower recovery process. After recovery, the application of aloe vera can help reduce scarring. It is important to take good care of the incision, eat plenty of vegetables to prevent constipation, and protect the incision. At least two weeks of rest is necessary after the surgery, during which vigorous exercise should be avoided.

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Written by Ren Zheng Xin
Gastroenterology
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Is appendicitis prone to recurrence?

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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What should I do about acute appendicitis?

Once acute appendicitis is diagnosed and surgical contraindications are ruled out, appendectomy is usually performed. Currently, the most common method is laparoscopic appendectomy, which results in less intraoperative bleeding and quicker postoperative recovery. After the surgery, depending on the severity of the appendicitis, the use of antibiotics may be considered. Additionally, fasting is required on the day of the surgery, and a semi-liquid diet may be chosen for the first one or two days post-surgery. Three to four days after the surgery, foods like egg custard, vegetable soup, and rice can be eaten, before gradually transitioning back to a normal diet.