How to diagnose appendicitis

Written by Ren Zheng Xin
Gastroenterology
Updated on January 22, 2025
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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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General Surgery
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Diagnosis methods for chronic appendicitis

The diagnostic methods for chronic appendicitis mainly include medical history, clinical symptoms, physical examination, laboratory tests, and auxiliary examinations. Firstly, cases of chronic appendicitis generally have a history of acute appendicitis episodes. Clinically, it is mainly characterized by pain, discomfort, and dull pain in the lower right abdomen, often without a history of migratory lower right abdominal pain. In physical examinations, tenderness can be found in the lower right abdomen, and when chronic appendicitis flares up acutely, signs of peritonitis can manifest as rebound pain in the lower right abdomen. In laboratory tests, an increased white blood cell count can be observed. Auxiliary examinations may reveal thickening of the appendix wall and obstruction in the appendix lumen due to fecaliths. Therefore, chronic appendicitis can be diagnosed through methods such as medical history, clinical symptoms, physical examination, laboratory tests, and auxiliary examinations.

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General Surgery
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How long after appendicitis can one have intercourse?

Regarding how long after appendectomy one can engage in sexual activities, it mainly depends on the treatment method used and the healing status after the surgery. Most cases of appendicitis can be treated with minimally invasive techniques, which not only cause less trauma and allow for quicker recovery but also reduce postoperative complications. The abdomen typically has two to three small puncture holes, each about one centimeter in length, and most patients can achieve sufficient strength to engage in sexual activities about a month after surgery. However, for traditional open surgery, the abdominal incision is usually longer, which may lead to incision infection and poor healing of the incision, and it generally takes about three months to achieve sufficient strength. For acute appendicitis, minimally invasive treatment is generally recommended, provided the patient's condition permits.

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Gastroenterology
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Is appendicitis nauseating?

Appendicitis can cause nausea, primarily due to inflammation stimulating spasms in the gastrointestinal tract. In addition to nausea, symptoms include vomiting, abdominal pain, tenderness in the abdomen, and rebound pain. If vomiting and nausea are severe, timely appendectomy should be performed. Currently, laparoscopic appendectomy is common. This surgical method involves less bleeding during surgery and quicker postoperative recovery. After surgery, a semi-liquid diet can be chosen on days 1 to 2, and a normal diet can be resumed on days 3 to 5. It is also important to consume more vegetables and increase the intake of plant-based fiber thereafter.

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Written by Ren Zheng Xin
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.

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Does chronic appendicitis cause a high fever?

Chronic appendicitis is just a common gastrointestinal disease. Generally, chronic appendicitis does not involve fever. However, a low-grade fever may occur when the inflammation in some cases of chronic appendicitis is not well-controlled. A small percentage of chronic appendicitis can acutely flare up and lead to a purulent infection, causing purulent appendicitis, which may lead to perforation of the appendix, diffuse peritonitis, septic shock, and high fever. Therefore, it is essential to actively treat chronic appendicitis, and early surgical intervention is recommended.