What is appendicitis?

Causes and Symptoms

Appendicitis may be acute or chronic. The inflammation characteristic of the condition may be associated with infection, or the causes may be various or even unknown.

In the human digestive system, the small intestine empties into the large intestine, or colon, in the lower right abdomen. Movement of waste from that point is generally upward through the ascending colon, but the colon begins with a downward-projecting blind end called the cecum, to which is attached the vermiform (“wormlike”) appendix. The appendix has no known function. Occasionally, its opening into the cecum becomes obstructed, and inflammation, swelling, and pain follow. Sometimes the cause of the obstruction is identifiable, such as parasitic pinworms or hardened fecal material; more often, it is not. Symptoms, including pain that is general at the outset but localizes in the lower right abdomen, can include nausea, fever, and an elevated white blood cell count. If the swollen appendix bursts, peritonitis—infection and poisoning of the abdominal cavity—can result. Peritonitis is usually signaled to the patient by
an abrupt cessation of pain, when the swelling is relieved, but is followed by serious and life-threatening complications.

Treatment and Therapy

The treatment of choice is almost invariably surgical removal of the inflamed appendix, an operation that is no longer considered major surgery. The patient is usually out of bed in a day or two and fully recovered in a few weeks. Peritonitis, however, calls for emergency surgery to remove the toxic material released by the ruptured appendix, as well as the appendix itself. Because a greater or lesser portion of the abdominal cavity must be cleansed with saline solution and treated with antibiotics, this surgery can become a major procedure.

Bibliography

A.D.A.M. Medical Encyclopedia. "Appendicitis." MedlinePlus, July 22, 2011.

Brodsky, Jason A., ed. "Appendicitis." National Digestive Diseases Information Clearinghouse, February 16, 2012.

Clayman, Charles B., ed. The American Medical Association Encyclopedia of Medicine. New York: Random House, 1994.

Krahenbuhl, L. Acute Appendicitis: Standard Treatment or Laparoscopic Surgery? New York: Karger, 1998.

Litin, Scott C., ed. Mayo Clinic Family Health Book. 4th ed. New York: HarperResource, 2009.

Wagman, Richard J., ed. The New Complete Medical and Health Encyclopedia. 4 vols. Chicago: J. G. Ferguson, 2002.

Wood, Debra, and Marcin Chwistek. "Appendicitis." Health Library, November 8, 2012.