Appendicitis

Introduction The appendix is a small organ. It is a tube that is attached to a part of the large intestine called the colon. Appendicitis is an infection of the appendix. It causes severe abdominal pain. Appendicitis causes a buildup of pressure in the appendix. The appendix can break open if it is not treated, causing infection to leak into the body. This can lead to death. This reference summary discusses appendicitis. It will address its symptoms, causes, risk factors and treatment. The Appendix The appendix is a pouch. It is about the size of a finger. It is attached to the first part of the large intestine. It is located in the lower right area of the abdomen. The inside of the appendix is called the appendiceal lumen. Mucus is created by the appendix. It travels through the appendiceal lumen. Then, it empties into the large intestine. Mucus is a thick, slippery fluid made by tissues that line certain organs of the body.

The Appendix

Scientists are not sure what role the appendix plays in the body. It may not affect anything. Removing it does not appear to affect a person's health. Symptoms Most people with appendicitis have classic symptoms. The main symptom is pain in the abdomen. The abdominal pain usually: • Happens suddenly. It may wake a person from sleep. • Happens before other symptoms. This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com Last reviewed: 06/07/2016

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With appendicitis, the pain often: • Begins near the belly button and moves lower and to the right. • Is new and unlike any pain felt before. • Gets worse in a matter of hours. • Gets worse when moving, taking deep breaths, coughing or sneezing. Other symptoms of appendicitis may include: • A low fever. • Distention of the abdominal area. • Constipation or diarrhea. • Inability to pass gas. • Loss of appetite. • Nausea or vomiting. • The feeling that passing stool will relieve discomfort. Causes Appendicitis is caused by a blockage. This block causes mucus to back up in the appendiceal lumen. Bacteria that live inside the appendix multiply and grow. The infected appendix then swells. The problem could be: • Feces, parasites or growths that cause a clog. • Enlarged tissue in the wall of the appendix due to an infection somewhere else in the body. • Inflammatory bowel disease. • Trauma to the abdomen. Complications Appendicitis can cause severe complications. It can cause: • The appendix to burst open. • Pus to fill the abdomen. Pus is a thick yellow or green liquid. It is made in infected tissue. It contains dead white blood cells, bacteria, tissue debris and serum. Serum is a brown colored liquid that is rich in protein.

Burst Appendix

This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com Last reviewed: 06/07/2016

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A swollen appendix will most likely burst if it is not taken out. The infection can spread through the abdomen if it bursts. The spread of the infection could cause peritonitis. This is a serious problem. It causes swelling of the tissue that lines the abdominal wall and covers most of the organs in the abdomen. It is very painful. A pocket of infection may form if your appendix bursts. This is known as an appendiceal abscess. It will form around the appendix. If the abscess tears, it could cause more infection in the rest of the body. Diagnosis Health care providers can diagnose most cases of appendicitis. They will ask you about your health history. They will also perform a physical exam. The health care provider will want to know when the pain began. He or she will want to know its exact location and how severe it is. To diagnose appendicitis, your doctor will need you to provide plenty of details about the pain. The health care provider will investigate the pain by touching or applying pressure to specific areas of the abdomen. Women of childbearing age may have a pelvic exam. This can rule out conditions that affect the female reproductive organs. These can sometimes cause pain that is similar to appendicitis. The health care provider may also examine the rectum. Appendicitis can make the rectum feel tender. A health care provider may use lab tests and imaging tests to confirm appendicitis. Tests may also help diagnose appendicitis in people who are not able to describe their symptoms, such as children. Blood tests are used to check for signs of infection. They will check for a high white blood cell count. These tests may also show signs of dehydration or electrolyte imbalances. Dehydration is a condition caused by the loss of too much water from the body. Severe diarrhea or vomiting can cause dehydration. Electrolytes are substances needed for cells to function normally. They also help nerves, muscles, the heart and the brain work the way they should. An example is salt. An electrolyte imbalance happens when the body does not have a healthy amount of electrolytes.

This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com Last reviewed: 06/07/2016

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Samples of urine may also be tested. This can rule out a urinary tract infection. Health care providers may also order a pregnancy test for women. CT scans can help diagnose appendicitis. They can also detect other sources of pain in the abdomen. Ultrasound is sometimes used to look for signs of appendicitis. It is used most often if the patient is thin or young. CT scans take a series of detailed pictures. They are pictures of areas inside the body taken from different angles. The pictures are created by a computer that is linked to an x-ray machine. Ultrasound is a procedure in which high-energy sound waves are bounced off internal tissues or organs. This makes an echo. The echo patterns are shown on the screen of an ultrasound machine. This forms a picture of body tissues. Treatment Appendicitis is often treated by removing the appendix. Surgery to remove the appendix is called appendectomy. A typical appendectomy takes less than an hour. It can be done two ways. An open method called mini-laparotomy removes the appendix through a single incision. The incision is made in the lower right area of the abdomen. The appendix can also be removed laparoscopically. Several small incisions are made. A camera and instruments are used to take the appendix out. A laparoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue to be checked under a microscope for signs of disease. Surgery sometimes shows that the appendix is normal. Many surgeons will take out the healthy appendix anyway. This will prevent the future chance of appendicitis. Sometimes the surgery reveals a different problem. This may also be fixed at that time. If an infection has formed around the appendix, it may be drained before surgery. This infected area is called an abscess. A tube is placed in the abscess through the abdominal wall. A CT scan is used to help find the abscess. The tube is left in place for about 2 weeks. Antibiotics are given to treat the infection. The infection and swelling will be under control six to eight weeks later. Surgery is then performed to remove what remains of the burst appendix. This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com Last reviewed: 06/07/2016

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A person may not be well enough to have surgery. The diagnosis may not be clear or surgery may not be an option. In these cases, non-surgical treatment may be used. This includes antibiotics to treat the infection and a liquid or soft diet until the infection goes away. Antibiotics are often given to treat bacterial infections. They can make the time you are sick shorter. Make sure you take them as your doctor tells you to. The infection can get worse if you stop early. Summary Appendicitis is an infection of the appendix. It causes pain and swelling of the appendix. The swelling causes mucus to back up in the appendiceal lumen. This lets bacteria that live inside the appendix breed and grow. The appendix can break open if it is not treated and the infection can leak out. If this happens, it is a serious medical problem. If pus from the burst appendix leaks into other parts of the abdomen, it can spread the infection and possibly lead to death. The main symptom of appendicitis is pain in the abdomen. The abdominal pain usually happens suddenly near the belly button and moves lower and to the right. The pain is unlike any pain felt before. It gets worse when moving, breathing, coughing or sneezing. A health care provider can diagnose most cases of appendicitis. He or she will ask you about your health history and perform a physical exam and medical tests. If appendicitis is highly suspected then surgery is needed to take it out. Surgery to remove the appendix is called appendectomy. It can be done through a mini-laparotomy, in which the appendix is removed through a single incision. It can also be taken out laparoscopically. Most people recover quickly after having their appendix removed. Recognizing the symptoms is important to a quick recovery. If you believe you have symptoms of appendicitis, immediately contact your health care provider. Early treatment can help you avoid the dangerous complications of appendicitis.

This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com Last reviewed: 06/07/2016

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