Updated: January 11, 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.
The appendix is a closed-ended, narrow, worm-like tube which is attached to the the first part of the colon called cecum. The wall of the appendix contains lymphatic tissue which is a part of the immune system. The inner lining of the appendix produces a small amount of mucus. The mucus flows through the open central core of the appendix into the cecum.
The wall of the appendix also contains a layer of muscle, which is poorly developed.
The most common complication of appendicitis is perforation. This can lead to a collection of infected pus known as peri-appendiceal abscess. Infection of the entire lining of the abdomen and the pelvis known as diffuse peritonitis also occurs due to perforation of the appendix.
Delay in diagnosis and treatment is the major reason for appendiceal perforation. The longer the delay between diagnosis and surgery, the more likely is perforation. Once appendicitis is diagnosed and if the patient does not improve with antibiotics alone, surgery should be done without unnecessary delay.
Blockage or obstruction of the intestine is another complication of appendicitis. When the inflammation surrounding the appendix compresses the intestine blockage occurs which prevents the content of the intestine from passing. If the intestine above the blockage begins to fill with liquid and gas, the abdomen distends and greater nausea and vomiting may occur. Contents of the intestine may then may be necessary to drain. This can be done with the help of a tube which will be passed through the nose and esophagus and into the stomach and intestine.
A severe complication of appendicitis is sepsis, in which infecting bacteria enter the blood and travel to other parts of the body. This condition is very serious and even life-threatening.
There are no major, long-term health problems resulting from removing the appendix in older children and adults. However in young children it may have an immune function.
The conditions that mimic appendicitis are:
Sexually active women may contract infectious diseases that involve the tube and ovary which ovary lie near the appendix. Usually, the infection can be treated with antibiotic therapy and surgical removal of the tube and ovary are not required.
If fluids from the right upper abdomen drain into the lower abdomen, inflammation may occur and mimic appendicitis. Such fluids may come from a perforated duodenal ulcer, gallbladder disease, or inflammatory diseases of the liver, such as a liver abscess.
Diverticulum is a small outpouching of the small intestine which is usually located in the right lower abdomen near the appendix. The diverticulum may become inflamed or even perforate which then required to be removed surgically.
Although most diverticuli are located on the left side of the colon, they occasionally occur on the right side. Rupture of a right-sided diverticulum can cause inflammation that mimics appendicitis.
As the right kidney is close to the appendix, inflammatory problems in the kidney, such as an abscess can mimic appendicitis.
If the fetus implants in the fallopian tube or elsewhere instead of the uterus, it is known as ectopic pregnancy and the symptoms may mimic appendicitis.