Updated: January 9, 2018
Appendicitis is inflammation of the appendix. It is a medical emergency that requires prompt surgery to remove the appendix. An inflamed appendix will eventually burst or perforate resulting in spilling infectious materials into the abdominal cavity if left untreated. This can lead to serious inflammation of the lining of abdominal cavity known as peritonitis. This can be fatal unless it is treated quickly with strong antibiotics.
It may be acute or chronic. Appendicitis can happen at any age, but mostly occurs between the ages of 10 to 30 and is more common in males than in females.
Indigestion or other gas-related pain are common symptoms of appendicitis. Appendicitis pain may start off as mild cramping which becomes more steady and severe over time.
Other symptoms of appendicitis may include:
Appendicitis is primarily associated with stomach pain, but this pain can also be felt in your sides or back. This pain will worsen if you move, walk, or even cough. Appendicitis can sometimes affect urination. You should avoid taking laxatives or having an enema as it may cause your appendix to burst. If you have tenderness on your right side along with any of these other symptoms, it may seek medical attention.
In teens, appendicitis can begin as a severe stomachache near the navel. This pain may progress to the lower right side of the abdomen. Rest other symptoms are same as they are for adults.
Appendicitis begins when the opening from the appendix into the cecum becomes blocked or obstructed. The blockage may be due to a build-up of thick mucus within the appendix or an accumulation of stool that enters the appendix from the cecum. When the mucus or stool hardens, becomes rock-like called fecalith which blocks the opening.
Obstruction can also be due to enlarged lymphoid follicles, worms, trauma or tumors. Bacteria which normally are found within the appendix begin to multiply and infect the wall of the appendix after the blockage. This leads to the formation of pus, compression of local blood vessels and inflammation. Inflammation that causes swelling and buildup of pressure within the appendix can be painful which can lead to rupture. A lack of blood flow to the appendix may cause gangrene.
If the appendix ruptures, fecal matter can fill the abdomen which is a medical emergency. Sometimes an inflammation of the tissue that lines the abdominal wall called peritonitis happens as a consequence of a ruptured appendix. Other organs such as cecum, bladder, and sigmoid colon can also become inflamed after a rupture. After rupture, infection can spread throughout the abdomen. Usually it is confined to a small area surrounding the appendix by the surrounding tissues, forming a peri-appendiceal abscess.
The inflammation, pain, and symptoms also may disappear when antibiotics are used in elderly patients. Over time it can result in a lump or a mass in the right lower abdomen which is due to the scarring that occurs during healing. This lump might lead to cancer.
Acute appendicitis is the most common non-obstetric emergency during pregnancy which requires surgery. It usually occurs during the second or third trimester of pregnancy. The symptoms may be mistaken for routine discomfort associated with pregnancy which can make the diagnosis difficult.
Delayed diagnosis can increase the risk of complications, including fetal loss and perforation or rupture. Treatment for a pregnant women with appendicitis is same as for who are not pregnant.