Location of pain in acute appendicitis

Written by Ren Zheng Xin
Gastroenterology
Updated on June 21, 2025
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Acute appendicitis mostly presents as abdominal pain, initially around the navel or throughout the abdomen, then gradually shifts to the lower right abdomen, and the pain becomes localized. If the appendix is situated behind the peritoneum, there can also be pain in the lower back area. Besides pain, other symptoms include vomiting and fever. For acute appendicitis, surgery is commonly required, often performed through laparoscopic appendectomy. This type of surgery involves minimal bleeding and a quicker recovery, qualifying as a minimally invasive treatment. Postoperative care is important, including regular dressing changes for the surgical site, with stitches typically being removed seven to eight days after the surgery.

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Written by Ren Zheng Xin
Gastroenterology
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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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Causes of Acute Appendicitis

The causes of acute appendicitis mainly include two types: one is the obstruction of the appendiceal lumen, and the other is infection within the appendiceal lumen. The appendix is a tube that communicates with the cecum. If it is blocked by fecoliths or fecal masses, it can lead to increased pressure inside the appendiceal lumen, damage to the mucosa, and bacterial invasion causing infection, which directly leads to acute inflammation. At the same time, gastrointestinal dysfunction can also cause spasm of appendix muscles and blood vessels, leading to blood supply disturbances. Irregular lifestyle habits, overeating, and engaging in vigorous activities after meals can all trigger acute appendicitis.

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Written by Ren Zheng Xin
Gastroenterology
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The etiology of acute appendicitis

The main cause of acute appendicitis is due to the narrowing of the appendiceal lumen, which can easily lead to the obstruction of food residues and fecal masses. Following the obstruction, mucosal damage occurs, which leads to secondary infections. Additionally, neglecting regular living habits, such as overeating, excessive fatigue, and frequent heavy drinking can exacerbate or trigger acute appendicitis. Therefore, maintaining regular living habits in daily life, such as having meals at fixed times, reasonable rest and work schedules, balancing work and leisure, and engaging in appropriate outdoor activities, can play a positive role in preventing acute appendicitis.

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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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Written by Ren Zheng Xin
Gastroenterology
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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.