About Appendicitis / Appendix

Appendicitis is among the most frequent surgical emergencies, with an estimated global age-adjusted incidence of 229.9 per 100,000 people. It peaks in individuals aged 15 to 19 and carries a lifetime risk of 8.6% for males and 6.7% for females.

What is Appendicitis / Appendix?

Appendicitis is the inflammation of the appendix—a small finger-like pouch attached to the large intestine. It typically results from a blockage due to hardened stool, infection, or other obstructions, causing pain, swelling, and a risk of rupture. This condition requires urgent medical intervention, usually surgical.

Appendicitis / Appendix : Signs and Symptoms

• Fever: Seen in about 40% of cases, fever can signal the immune system’s response and the spread of infection.
• Malaise: A general sick feeling, fatigue, and the desire to stay in bed may develop.
• Abdominal swelling: The belly may appear enlarged, especially if the appendix has burst.
• Urinary complaints: Frequent urination or urgency may occur due to nerve irritation.
• Bowel changes: The gut may temporarily stop functioning, leading to constipation and gas.
• Loose stools: In some people, inflammation affects nearby bowel segments, causing diarrhea.

Appendicitis / Appendix Causes

Due to its small size and location, the appendix can easily become infected. The large intestine is full of bacteria, and if these get trapped inside the appendix, it can lead to inflammation.

Main causes include:

• Fecaliths: Hard stool deposits may clog the appendix opening, carrying or trapping bacteria.
• Lymphoid enlargement: Infections elsewhere can cause swelling in lymph tissue within the appendix.
• Colon inflammation: Infections or IBD in the colon can irritate or involve the appendix.
• Other triggers: Tumors, worms, or conditions like cystic fibrosis may obstruct the appendix.

Appendicitis / Appendix Complications

• Loss of blood flow and tissue death: Severe swelling can block circulation, leading to necrosis.
• Rupture or gangrene: Decaying tissue can burst, spreading infection internally.
• Abscess or phlegmon: Infection may stay localized as pus collections or inflamed masses.
• Peritonitis or sepsis: Spread of infection into the abdomen or blood may lead to life-threatening illness.

Appendicitis / Appendix Diagnosis

Appendicitis is confirmed by symptoms, lab results, and imaging tests.

• Evaluation: Pain in the lower right abdomen, especially rebound tenderness and rigidity, is typical.
• Blood work: High white blood cells and CRP indicate infection and inflammation.
• Urinalysis & pregnancy test: Help rule out other causes like UTI or ectopic pregnancy.
• Ultrasound: First choice in children and pregnant women—no radiation but some limitations.
• CT scan: Best accuracy in adults but includes radiation and contrast.
• MRI: Radiation-free option for pregnancy or when ultrasound is unclear.

Appendicitis / Appendix Treatment Options

1. Appendectomy (Surgical Removal)

• Advanced Laparoscopic Surgery:
  
  • Procedure: Several tiny cuts allow camera-guided appendix removal.
  • Advantages: Less recovery time, smaller scars, and lower postoperative discomfort.
• Open Surgery:
  
  • Procedure: One larger cut used in complicated cases.
  • Indications: Ideal for ruptured appendices, abscess, or widespread infection.

2. Drainage Before Surgery

• For Abscesses: Involves image-guided drainage, followed by appendectomy later on.