Appendicitis

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What is it about ?

Appendicitis is inflammation of the appendix. The appendix is ​​a small, worm-shaped outgrowth located at the end of the cecum and measuring on average 9 cm.

Caecum

The cecum is a pocket (dead end) corresponding to the last portion of the large intestine. It is located at the bottom right of the belly, at the level of the transition between the small intestine and the large intestine.

Cause

Appendicitis is often caused by a narrowing or obstruction of the appendix, most often from a small piece of hardened stool.

Complications

When appendicitis appears suddenly, within hours or days, it is called acute appendicitis. If treatment is not started quickly, the situation can get more complicated:

  • the inflamed appendix may burst;
  • an abscess may form;
  • the lining of the intestines (the peritoneum) can become inflamed (peritonitis): this complication can be fatal and must be treated urgently.
What is its frequency?

Acute appendicitis is less and less common. In the general population, 7 in 100 people suffer from acute appendicitis at one time or another.

Where do we meet her?

Usually appendicitis occurs between the ages of 10 and 30, but it occurs in all age groups.

How to recognize it?

Stomach aches
  • You usually feel a pain in the stomach, lower right. This pain quickly gets worse. This is the characteristic symptom of appendicitis.
  • You may also first feel severe pain around the belly button. After a few hours or a few days, it moves down to the right.
  • You may have pain in another place. This is because the exact position of the appendix varies from person to person.
Other symptoms
  • You may also have a loss of appetite, nausea and vomiting.
  • You have a fever and you feel unwell.
  • Passing on a bumpy road triggers pain. Coughing, running and jumping are also painful.

How is the diagnosis made?

Discussion and clinical examination

The doctor usually thinks of appendicitis on the basis of the characteristic symptoms and the observations on the physical examination.

  • The lower right part of the stomach is tender and the stomach muscles are tense.
  • When pressing on the stomach, you feel pain. When you let go, the pain persists.
Blood test

The doctor may also take a blood sample to check for inflammation and infection.

Imaging exams

If in doubt the diagnosis, the doctor will also give you a ultrasound or a CT scan. These tests will help her determine if you have appendicitis or something else. Indeed, a large number of conditions cause acute stomach aches, especially in women (for example, intestinal infection, urinary tract infections, kidney stone, gynecological infections, ectopic pregnancy, etc.).

Exploratory surgery

If the diagnosis is still not clear after imaging tests, exploratory surgery may be necessary. This means that we operate to find the cause of the pain. If the appendix is ​​inflamed, then the doctor can remove it immediately.

What can you do ?

You feel severe pain in the belly on the lower right and you think of appendicitis? It is better to consult a doctor as soon as possible. Appendicitis must be treated quickly to avoid complications.

What can your doctor do?

Remove the appendix

To treat appendicitis, a surgeon usually needs to remove the appendix during an operation (appendectomy). The operation is usually performed laparoscopically: the surgeon makes three small cuts (incisions) in the stomach, this allows him to pass a small camera and instruments to view and remove the appendix. This operation is performed under general anesthesia. During the operation, you are given antibiotics as an infusion.

Antibiotic therapy
  • In the case of early appendicitis with mild symptoms, antibiotics alone may sometimes be sufficient.
  • If the peritoneum is inflamed (peritonitis), a surgeon should rinse the abdominal cavity as soon as possible during an operation. During the procedure, antibiotics are given as an infusion.
  • If an abscess has developed, the doctor will give you antibiotics against the bacteria characteristic of the abscess. Eventually, a surgeon can remove the appendix.

Want to know more?

Source

Foreign clinical practice guide ‘Acute appendicitis’ (2012), updated on 03/30/2017 and adapted to the Belgian context on 05/22/2019 – ebpracticenet