BASIC INFORMATION
DESCRIPTION
Inflammation of the vermiform appendix, a small
intestinal pouch that extends from the cecum, the first
part of the large intestine. The appendix has no known
function, but it can become diseased. Appendicitis
affects 1 in 500 people each year. Symptoms vary widely.
Appendicitis should be considered in any person
with undiagnosed abdominal pain. It affects all ages
(men more than women), but is rare in children under
2. The incidence peaks between ages 15 and 24.
FREQUENT SIGNS AND SYMPTOMS
Pain that begins close to the navel and migrates
toward the right lower abdomen. Pain becomes persistent
and well-localized. It worsens with moving, breathing
deeply, coughing, sneezing, walking or being
touched.
Nausea and sometimes vomiting.
Constipation and inability to pass gas.
Diarrhea (occasionally).
Low fever, beginning after other symptoms.
Tenderness in the right lower abdomen, usually about
a third of the distance from the navel to the top of the
hip bone. (This description applies only if the appendix
is in its normal position. In some cases, the tip of the
appendix is located elsewhere, making diagnosis difficult).
Abdominal swelling (late stages).
Increased white-blood-cell count.
CAUSES
Infection for unknown reason, usually with bacteria
from the intestinal tract. The appendix may become
obstructed from contents moving through the intestinal
tract or by a constricting band of tissue. When infected,
it becomes swollen, inflamed and filled with pus.
RISK INCREASES WITH
Recent illness, especially a roundworm infestation or
gastrointestinal virus infection.
PREVENTIVE MEASURES
No specific preventive measures.
EXPECTED OUTCOMES
Usually curable with surgery. If totally untreated, a ruptured
appendix is fatal.
POSSIBLE COMPLICATIONS
Rupture of the appendix, abscess formation and peritonitis.
This is more common in older persons.
Misdiagnosis because of few or atypical symptoms,
especially in the very young or very old.
Formation of an abscess.
TREATMENT
GENERAL MEASURES
Diagnostic tests may include laboratory blood studies
(show higher levels of white blood cells) and urinalysis
to rule out a urinary-tract infection, which can mimic
appendicitis.
While diagnosis is uncertain, take a rectal temperature
every 2 hours. Keep a record.
Surgery to remove the appendix (appendectomy).
Because appendicitis can be hard to diagnose, surgery is
often withheld until symptoms and signs progress
enough to confirm the diagnosis.
If an abscess has formed, surgery may be delayed until
the abscess is drained and has time to heal.
MEDICATIONS
Don't take any laxatives, enemas or medicines for
pain. Laxatives may cause rupture, and pain or fever
reducers make diagnosis more difficult.
Pain medicine will be prescribed after surgery.
Antibiotics if infection is present.
Stool softeners to prevent constipation may be recommended.
ACTIVITY
Rest in a bed or chair until surgery.
Resume normal activities gradually after surgery.
DIET
Don't eat or drink anything until appendicitis has
been diagnosed. Anesthesia for surgery is much safer if
the stomach is empty. If you are very thirsty, wash your
mouth out with water.
A liquid diet, progressing to soft diet following
surgery.
NOTIFY YOUR PHYSICIAN IF
- You or a family member has symptoms of appendicitis.
- The following occur while surgery is pending or after
surgery:
Fever of 102°F (38.9° C) or over.
Continued vomiting.
Increased pain in the abdomen.
Fainting.
Blood in the stool or vomit.
Dizziness or headache.
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