Symptoms of acute appendicitis

Written by Ren Zheng Xin
Gastroenterology
Updated on September 03, 2024
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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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Gastroenterology
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acute appendicitis symptoms

The symptoms of acute appendicitis typically include abdominal pain at the onset of the condition, which initially occurs around the navel and then localizes to the lower right abdomen, as well as early nausea and vomiting caused by gastric spasms. Patients with more severe inflammation may also exhibit fever. If the inflammation spreads to the peritoneum, there will be tenderness at McBurney's point and rebound tenderness, along with tense abdominal muscles. Based on these symptoms, making a definitive diagnosis of acute appendicitis is not particularly difficult.

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Acute appendicitis complications

The main complications of acute appendicitis include: First, purulent peritonitis, due to the appendix becoming purulent and leading to perforation, pus flows into the abdominal cavity, causing diffuse peritonitis; Second, abdominal abscess, purulent appendicitis that is not treated surgically forms a capsule around the appendix, encapsulating it, and a lump can be felt on the abdominal surface; Third, internal-external fistula, if the abscess around the appendix is not drained in time, it can break through to the intestinal abdominal wall, forming a fistula.

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How is acute appendicitis treated?

Acute appendicitis treatment primarily involves surgical methods, where the inflamed, suppurative, or perforated appendix is excised during the procedure, and then the base of the appendix is sutured. Moreover, if there is suppuration, it is necessary to irrigate the peritoneal cavity to prevent intra-abdominal infections. After the surgery, fluid therapy should be administered based on the patient's condition. In cases of perforation or suppuration, antibiotics should be used post-operatively. For simple appendicitis, post-operative fluid replenishment is generally sufficient, and antibiotics are not required. (Please use medications under the guidance of a doctor.)

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Anesthesia methods for acute appendicitis

The anesthesia method for acute appendicitis is related to the type of surgical treatment. If laparoscopic appendectomy is chosen, general anesthesia is usually required. If a traditional McBurney point incision is used for appendectomy, spinal anesthesia is primarily chosen. Additionally, after anesthesia, gastrointestinal function will be somewhat restricted. Until there is no gas or bowel movement from the rectum, patients should not eat after surgery. Only when the rectum starts to pass gas, indicating that gastrointestinal function is beginning to recover, can the patient begin to consume soft foods.

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Which is more serious, acute appendicitis or chronic appendicitis?

The symptoms of acute appendicitis are relatively more severe because acute suppurative appendicititis can cause perforation of the appendiceal lumen. After the perforation, pus can flow into the abdominal cavity causing diffuse peritonitis, leading to abdominal muscle tension, tenderness, and rebound pain. If not treated promptly, it can lead to multiple organ failure. Chronic appendicitis is mostly due to incomplete treatment of acute appendicitis, or chronic latent appendicitis. The symptoms of chronic appendicitis are sometimes mild and the physical signs are not definite. Surgical removal of the appendix should be the first choice for treating acute appendicitis.