Can appendicitis cause a fever?

Written by Zhu Dan Hua
Gastroenterology
Updated on October 25, 2024
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Appendicitis can cause fever, and generally, it is considered an inflammatory condition. Besides fever, patients may experience abdominal pain, nausea, vomiting, etc. Typically, the abdominal pain manifests as lower right quadrant pain, which is referred pain. If a patient has fever and typical lower right quadrant pain, further investigations like abdominal ultrasound, complete blood count, and CT scans should be carried out. Diagnosing appendicitis is usually not difficult. The treatment of choice for appendicitis is generally surgical intervention, especially for early-stage patients with symptoms lasting less than three days, where an appendectomy is recommended. However, in some elderly patients with conditions like hypertension, diabetes, etc., who are not suitable for surgery, especially if the duration of the illness is more than three days, conservative medical treatment can be chosen. Conservative treatment primarily involves active anti-infection and anti-inflammatory measures and usually takes longer. (Medication should be administered under the guidance of a doctor.)

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What to pay attention to with appendicitis

Patients with appendicitis should pay attention to diet adjustments and regular routines, as well as choosing the correct treatment method. Diet should be lighter, consume more vegetables, ensure smooth bowel movements, eat less raw, cold, and spicy foods, rest more, and avoid excessive fatigue, especially staying up late. Additionally, pay attention to active and effective treatments. Currently, surgical treatment is the main approach, and laparoscopic appendectomy can be chosen. This surgical method involves less bleeding during the operation and a faster postoperative recovery, requiring a rest period of two weeks post-surgery.

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Acute appendicitis clinical features

Acute appendicitis generally presents primarily as abdominal pain, specifically migratory pain to the lower right abdomen. Initially, the patient may experience stomach pain, which gradually shifts to pain in the lower right abdomen. Whether it is appendicitis needs to be diagnosed by a physical examination by a doctor, or an ultrasound of the appendix during the acute phase can be performed. If the appendix appears significantly swollen on the ultrasound, it can also confirm the diagnosis of acute appendicitis. Typically, the best treatment for acute appendicitis is surgery, especially if the condition is very severe and critical, as it may lead to perforation of the appendix and result in purulent peritonitis, which is very serious and life-threatening. Therefore, once diagnosed with acute appendicitis, it is best to be hospitalized for surgery.

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Appendicitis location

The location of appendicitis is generally in the lower right abdomen, as the appendix is mostly located in the right iliac fossa. There are very few cases of situs inversus, where it is located on the left, but the appendix usually originates from the base of the cecum, attached to the posterior wall of the cecum, at the confluence of the three taeniae coli. Therefore, the surface projection of the appendix is mostly at the junction of the outer one-third of the line connecting the navel and the right anterior superior iliac spine, which is also commonly used as the marking point for surgical incisions. In cases of appendicitis, there may be pain in the upper right abdomen or pelvic region due to changes in the position of the appendix. For confirmed diagnoses of appendicitis, surgery is generally considered, and minimally invasive methods can be chosen. If an abscess forms around the appendix and the patient's condition can be managed, conservative treatment is usually preferred initially, followed by elective removal of the appendix after three months.

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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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Appendicitis surgery, how many days to discharge?

This is directly related to the surgical method. If it is a laparoscopic appendectomy, this is a minimally invasive treatment, and recovery is quick; patients generally can be discharged from the hospital three days post-surgery, and sutures can be removed at a scheduled follow-up visit. If it is the traditional surgery method through McBurney's point incision, this method also allows for quick recovery, and patients can be discharged after the sutures are removed. Additionally, this also relates to the patient's physique and the severity of their condition. For elderly patients, the hospital stay may be extended. If the appendix has a clear perforation or causes diffuse peritonitis, the use of antibiotics must be intensified post-surgery, hence extending the treatment period. (The use of medications should be conducted under the guidance of a doctor)