How is acute appendicitis treated?

Written by Ren Zheng Xin
Gastroenterology
Updated on March 18, 2025
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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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Acute appendicitis surgery is where?

Acute appendicitis primarily involves the removal of the appendix, which is also the main purpose of surgical treatment. The traditional appendectomy through McBurney's point incision involves anesthesia at the waist area, making an incision at McBurney's point, ligating the appendiceal artery, removing the appendix from its base, and then suturing the end with a purse-string stitch. In laparoscopic appendectomy, performed under general anesthesia, the appendiceal artery is also ligated and the appendix removed, followed by suturing the end. Postoperative care should be enhanced to avoid excessive exertion.

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Written by Ren Zheng Xin
Gastroenterology
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The Difference Between Acute and Chronic Appendicitis

The differences between acute appendicitis and chronic appendicitis mainly lie in the onset of the condition, physical signs, and laboratory tests. First, regarding the onset of the condition, acute appendicitis occurs suddenly and can involve abrupt abdominal pain, whereas chronic appendicitis often manifests as fixed tenderness in the lower right abdomen and the symptoms are not particularly typical. In terms of physical signs, acute appendicitis presents with migratory pain in the lower right abdomen, while chronic appendicitis generally does not involve rebound pain. Thirdly, concerning auxiliary examinations, acute appendicitis shows a significant increase in the white blood cell count during an attack, whereas in chronic appendicitis, the white blood cell count may appear normal.

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Written by Ren Zheng Xin
Gastroenterology
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Does acute appendicitis hurt?

Acute appendicitis is associated with abdominal pain, the severity of which is directly related to the extent of the inflammation. If the inflammation is mild, the abdominal pain can be tolerable. However, if there is significant pus in the appendix or perforation, it can cause severe abdominal pain, similar to being cut by a knife. Acute appendicitis generally requires surgical treatment. Currently, a common procedure is laparoscopic appendectomy, which causes less bleeding during surgery and allows for a quicker recovery with minimal damage to the body. For patients who cannot tolerate general anesthesia, spinal anesthesia can be used, and the appendix can be removed through an incision at McBurney's point.

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Written by Ren Zheng Xin
Gastroenterology
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Acute Appendicitis Etiology

The cause of acute appendicitis is primarily bacterial infection of the appendiceal lumen due to various reasons. The appendix itself is a narrow tube connected to the cecum. If a fecalith falls into the lumen, it can cause obstruction of the appendiceal lumen, leading to an increase in intra-luminal pressure and circulatory disturbances in the appendiceal wall. At this time, the mucosa is susceptible to damage, and bacterial invasion of the wall can cause infections of varying degrees. Additionally, gastrointestinal dysfunction, such as diarrhea or constipation, can also cause spasms of the appendiceal vessels, leading to blood supply disturbances and resulting in acute inflammation.

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Written by Li Jin Quan
General Surgery
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The difference between chronic appendicitis and acute appendicitis

The difference between chronic appendicitis and acute appendicitis is that most cases of chronic appendicitis are formed after the treatment of acute appendicitis. Chronic appendicitis and acute appendicitis display different symptoms. Acute appendicitis has typical migratory pain in the lower right abdomen, which initially appears in the upper abdomen and then moves to McBurney's point in the lower right abdomen. Chronic appendicitis, on the other hand, often lacks upper abdominal pain and initially presents with fixed discomfort or vague pain in the lower right abdomen. Only when chronic appendicitis acutely flares up does significant tenderness in the lower right abdomen occur, and rebound pain appears with peritonitis. Chronic appendicitis may also occasionally present with gastrointestinal symptoms such as nausea and vomiting.