What department should I go to for appendicitis?

Written by Ren Zheng Xin
Gastroenterology
Updated on January 08, 2025
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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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Written by Ren Zheng Xin
Gastroenterology
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Is appendicitis contagious?

Appendicitis is an inflammation that occurs in the lumen of the appendix, including acute appendicitis and chronic appendicitis. Appendicitis is not contagious, as it is not an infectious disease, but rather a purulent inflammation. Therefore, there is no need to isolate patients with appendicitis. Appendicitis usually requires surgical removal, but it is important to note that surgery should not be performed if acute appendicitis has been present for more than 72 hours, or if an abscess has formed. The majority of surgeries are performed using laparoscopic appendectomy, a method which allows for a faster recovery post-operation.

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Gastroenterology
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Acute appendicitis pain level

The pain of acute appendicitis is mainly abdominal pain. Currently, there are no available data for reference to understand the level of pain in appendicitis, and the pain associated with acute appendicitis is related to the individual's constitution and the extent of inflammation in the appendix. If the inflammation is mild, limited only to the serosal layer, then the pain is relatively mild and tolerable. If the inflammation is more extensive or involves pus formation, perforation, and affects the peritoneum, it leads to noticeable peritonitis and causes severe, knife-like pain, making the patient scared to move and covered in profuse sweat; the pain is quite severe. For acute appendicitis, surgery is currently advocated as the treatment method.

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Gastroenterology
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How to diagnose appendicitis

Appendicitis is primarily diagnosed clinically through a physical examination. The patient is asked to lie flat, exposing the abdomen, with legs bent. The doctor stands on the patient’s right side and uses the right hand with fingers together to gently rub the abdomen, pressing on the McBurney's point. If there is significant pain, this is considered positive tenderness. Then, the doctor quickly lifts the fingers; if there is significant rebound pain, it is generally confirmed as acute appendicitis. During acute appendicitis, as the appendix lumen expands and the appendix becomes congested and edematous, ultrasound imaging can also show corresponding signs that serve as an auxiliary diagnosis. Once acute appendicitis is confirmed, it is mostly treated surgically.

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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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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.