How is acute appendicitis treated?

Written by Ren Zheng Xin
Gastroenterology
Updated on September 27, 2024
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The principle of treating acute appendicitis is to rehydrate and fight infection, complete related auxiliary examinations, and then carry out an emergency appendectomy. Acute appendicitis can be controlled by medication, but the effectiveness of medications is limited; most cases still require the removal of the appendix through surgery. Currently, laparoscopic appendectomy is an available option. This method is relatively more complex, but it allows for faster recovery and less trauma post-surgery, though it tends to be more expensive.

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Gastroenterology
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How is acute appendicitis diagnosed?

The diagnosis of acute appendicitis is primarily based on clinical symptoms, signs, and auxiliary examinations. The patient describes abdominal pain accompanied by nausea and vomiting. During the physical examination, migratory pain in the lower right abdomen and significant rebound tenderness upon palpation are noted. Additionally, ultrasound diagnostics suggest swelling of the appendix lumen, all indicative of acute appendicitis. For acute appendicitis, once confirmed, surgery is generally required to remove the appendix, which is the only way to completely cure acute appendicitis.

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Early symptoms of acute appendicitis

The symptoms of the early stage of acute appendicitis primarily include vague abdominal pain, initially across the abdomen, then transitioning around the belly button, and after several hours, shifting to the lower right abdomen where the pain becomes localized. The early symptoms of acute appendicitis are not typically distinctive, with the onset being quite sudden, accompanied by severe abdominal pain, vomiting, and fever. Based on these typical clinical manifestations, diagnosing acute appendicitis is not difficult. Clinically, the main treatment is the surgical removal of the appendix, with laparoscopic appendectomy being the more common practice nowadays. This method involves less bleeding during the operation and a quicker post-operative recovery.

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Symptoms of acute appendicitis

The typical symptoms of acute appendicitis include abdominal pain that starts around the upper abdomen or navel area, then localizes to the lower right abdomen. There are also manifestations of gastrointestinal spasms such as nausea and vomiting. Due to inflammation entering the bloodstream, there can be a systemic infection, often accompanied by fever, generally not exceeding 38 degrees Celsius. If there is an appendix perforation and peritonitis, the temperature can exceed 38 degrees. After the appendix becomes suppurative, symptoms can include abdominal muscle rigidity, dental pain, and rebound tenderness.

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Written by Ren Zheng Xin
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Typical symptoms of acute appendicitis

The typical symptoms of acute appendicitis include abdominal pain, which starts in the upper abdomen or around the navel and, after several hours, shifts and localizes to the lower right abdomen. Additionally, reflexive gastric spasms may cause nausea and vomiting. Due to the inflammation, the body may develop a fever, generally not exceeding 38 degrees Celsius. If the inflammation affects the parietal peritoneum, it can cause tenderness, rebound pain, and abdominal muscle rigidity. These are the typical symptoms, and a preliminary diagnosis can usually be made based on them. Most cases require an appendectomy.

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Gastroenterology
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Which is more serious, acute appendicitis or chronic appendicitis?

Acute appendicitis is relatively common in clinical practice with severe symptoms. Compared to chronic appendicitis, acute appendicitis can cause the appendix tube to become purulent and perforate, leading to a widespread peritonitis. Severe peritonitis can cause multi-organ failure and even shock. Chronic appendicitis, on the other hand, mainly manifests as chronic abdominal pain and seldom shows signs of appendix perforation. It primarily leads to an abscess around the appendix, encapsulating the appendix and causing repetitive chronic pain, which is difficult to heal. Both acute and chronic appendicitis should be treated surgically by removing the appendix to achieve a complete cure.