Where is appendicitis?

Written by Zhang Peng
General Surgery
Updated on June 15, 2025
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Appendicitis primarily occurs as inflammation in the lower right abdomen due to its association with the location of the appendix, which is most often situated in the right iliac fossa. In very rare cases, patients with malrotation of the intestine or situs inversus may have the appendix located on the left side, or it may be elevated due to specific conditions during pregnancy. Generally, the appendix is an intra-peritoneal organ and its position can be variable. However, because the base of the appendix has a relatively constant relationship with the cecum, there are typically six clinical manifestations of the appendix's position: pre-ileal, pelvic, retrocecal, subcecal, post-ileal, and lateral cecal positions. For cases of appendicitis with clear diagnosis, surgical treatment is predominantly considered.

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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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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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Can appendicitis be contagious?

Appendicitis is a nonspecific inflammation occurring in the lumen of the appendix. It is not contagious, therefore, it is not an infectious disease. Once appendicitis is diagnosed, it is mostly treated surgically because the main blood supply to the appendix is the appendicular artery, which can easily lead to ischemic necrosis during inflammation. If controlled solely by medication, symptoms are likely to recur easily. Currently, appendectomy is commonly performed using minimally invasive techniques, under laparoscopy, which results in less bleeding during surgery and faster recovery afterward. Generally, if there is no suppuration or perforation, patients can be discharged three days after surgery. Postoperative care should be enhanced, including eating more vegetables to prevent constipation.

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Acute appendicitis pain is on that side.

In the initial stages of acute appendicitis, pain can occur in the left side of the abdomen, then gradually move around the navel, and eventually becomes fixed in the lower right abdomen. The typical symptom of appendicitis is migratory pain in the lower right abdomen, which becomes severe upon pressing and intensifies when lifted, a phenomenon known as rebound tenderness. A small number of patients may experience pain in the lumbar and back areas, which could be due to inflammation caused by a retroperitoneal position. Based on the typical symptoms of appendicitis, a diagnosis cannot be confirmed. After confirmation, most cases require an appendectomy.

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Is surgery necessary for appendicitis?

Once appendicitis is diagnosed, most cases require surgical treatment because the blood supply to the appendix is quite unique, with only the appendicular artery providing blood flow. If appendicitis occurs, it can easily lead to ischemic necrosis of the appendix, resulting in gangrenous appendicitis. Currently, laparoscopic appendectomy is a common surgical procedure, which is a minimally invasive treatment. For elderly or frail individuals who cannot tolerate surgery, conservative treatment is the only option. Postoperative care should be enhanced, with regular dressing changes at the incision site, and stitches can generally be removed one week after surgery. A semi-liquid diet is recommended for one to two days after surgery, and a regular diet can be resumed three to four days post-operation.