Appendicitis location

Written by Zhang Peng
General Surgery
Updated on January 14, 2025
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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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Written by Ren Zheng Xin
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Is appendicitis prone to recurrence?

Appendicitis, if treated by surgically removing the appendix, generally does not recur and can be cured. However, if one only uses medication to control the symptoms during an attack of appendicitis, it can easily recur. For appendicitis, laparoscopic appendectomy is currently the preferred surgical treatment. This method involves less bleeding during surgery and quicker recovery post-surgery. For elderly or frail patients who cannot tolerate general anesthesia, the traditional surgical method involving an incision at McBurney's point can be chosen. With this method, it is important to rest more. Patients can usually be discharged about a week after surgery. Postoperative care should be strengthened, dietary adjustments should be made, and more vegetables should be eaten to prevent constipation.

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Written by Ren Zheng Xin
Gastroenterology
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Principles of Treatment for Acute Appendicitis

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 Li Jin Quan
General Surgery
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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.

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Written by Ren Zheng Xin
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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Written by Ren Zheng Xin
Gastroenterology
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Appendicitis pain location

Appendicitis initially presents with pain throughout the abdomen and around the navel, which gradually shifts to the lower right abdomen, and the pain becomes more localized. Besides abdominal pain, symptoms of appendicitis can also include nausea, vomiting, and fever. Most cases of appendicitis require surgical treatment. Currently, laparoscopic appendectomy is a common surgical method. This technique involves less bleeding during surgery, quicker postoperative recovery, and minimal scarring. If one cannot tolerate general anesthesia, an option is to remove the appendix through an incision at McBurney's point.