Acute appendicitis


Does acute appendicitis hurt?
Acute appendicitis is associated with abdominal pain, the severity of which is directly related to the extent of the inflammation. If the inflammation is mild, the abdominal pain can be tolerable. However, if there is significant pus in the appendix or perforation, it can cause severe abdominal pain, similar to being cut by a knife. Acute appendicitis generally requires surgical treatment. Currently, a common procedure is laparoscopic appendectomy, which causes less bleeding during surgery and allows for a quicker recovery with minimal damage to the body. For patients who cannot tolerate general anesthesia, spinal anesthesia can be used, and the appendix can be removed through an incision at McBurney's point.


How is acute appendicitis treated?
Acute appendicitis treatment primarily involves surgical methods, where the inflamed, suppurative, or perforated appendix is excised during the procedure, and then the base of the appendix is sutured. Moreover, if there is suppuration, it is necessary to irrigate the peritoneal cavity to prevent intra-abdominal infections. After the surgery, fluid therapy should be administered based on the patient's condition. In cases of perforation or suppuration, antibiotics should be used post-operatively. For simple appendicitis, post-operative fluid replenishment is generally sufficient, and antibiotics are not required. (Please use medications under the guidance of a doctor.)


Which is more serious, acute appendicitis or chronic appendicitis?
Acute appendicitis is relatively common in clinical practice with severe symptoms. Compared to chronic appendicitis, acute appendicitis can cause the appendix tube to become purulent and perforate, leading to a widespread peritonitis. Severe peritonitis can cause multi-organ failure and even shock. Chronic appendicitis, on the other hand, mainly manifests as chronic abdominal pain and seldom shows signs of appendix perforation. It primarily leads to an abscess around the appendix, encapsulating the appendix and causing repetitive chronic pain, which is difficult to heal. Both acute and chronic appendicitis should be treated surgically by removing the appendix to achieve a complete cure.


How is acute appendicitis diagnosed?
The diagnosis of acute appendicitis is primarily based on clinical symptoms, signs, and auxiliary examinations. The patient describes abdominal pain accompanied by nausea and vomiting. During the physical examination, migratory pain in the lower right abdomen and significant rebound tenderness upon palpation are noted. Additionally, ultrasound diagnostics suggest swelling of the appendix lumen, all indicative of acute appendicitis. For acute appendicitis, once confirmed, surgery is generally required to remove the appendix, which is the only way to completely cure acute appendicitis.


Does acute appendicitis cause vomiting?
Acute appendicitis can cause vomiting due to inflammation stimulating spasms in the gastrointestinal tract. In addition to vomiting, another typical symptom is abdominal pain, which starts around the navel and shifts to the lower right abdomen, and it is more commonly fixed in the lower right abdomen. The inflammation entering the bloodstream also causes fever, generally not exceeding 38.5°C. If there is significant pus formation or appendix perforation, it can cause high fever. The treatment primarily involves surgical removal of the appendix, with laparoscopic appendix removal being commonly used nowadays. This surgical method has less bleeding during the operation and a faster recovery afterward.


acute appendicitis symptoms
The symptoms of acute appendicitis typically include abdominal pain at the onset of the condition, which initially occurs around the navel and then localizes to the lower right abdomen, as well as early nausea and vomiting caused by gastric spasms. Patients with more severe inflammation may also exhibit fever. If the inflammation spreads to the peritoneum, there will be tenderness at McBurney's point and rebound tenderness, along with tense abdominal muscles. Based on these symptoms, making a definitive diagnosis of acute appendicitis is not particularly difficult.


How is acute appendicitis treated?
The principle of treating acute appendicitis is to rehydrate and fight infection, complete related auxiliary examinations, and then carry out an emergency appendectomy. Acute appendicitis can be controlled by medication, but the effectiveness of medications is limited; most cases still require the removal of the appendix through surgery. Currently, laparoscopic appendectomy is an available option. This method is relatively more complex, but it allows for faster recovery and less trauma post-surgery, though it tends to be more expensive.


Typical symptoms of acute appendicitis
The typical symptoms of acute appendicitis include abdominal pain, which starts in the upper abdomen or around the navel and, after several hours, shifts and localizes to the lower right abdomen. Additionally, reflexive gastric spasms may cause nausea and vomiting. Due to the inflammation, the body may develop a fever, generally not exceeding 38 degrees Celsius. If the inflammation affects the parietal peritoneum, it can cause tenderness, rebound pain, and abdominal muscle rigidity. These are the typical symptoms, and a preliminary diagnosis can usually be made based on them. Most cases require an appendectomy.


The etiology of acute appendicitis
The main cause of acute appendicitis is due to the narrowing of the appendiceal lumen, which can easily lead to the obstruction of food residues and fecal masses. Following the obstruction, mucosal damage occurs, which leads to secondary infections. Additionally, neglecting regular living habits, such as overeating, excessive fatigue, and frequent heavy drinking can exacerbate or trigger acute appendicitis. Therefore, maintaining regular living habits in daily life, such as having meals at fixed times, reasonable rest and work schedules, balancing work and leisure, and engaging in appropriate outdoor activities, can play a positive role in preventing acute appendicitis.


The difference between chronic appendicitis and acute appendicitis
The difference between chronic appendicitis and acute appendicitis is that most cases of chronic appendicitis are formed after the treatment of acute appendicitis. Chronic appendicitis and acute appendicitis display different symptoms. Acute appendicitis has typical migratory pain in the lower right abdomen, which initially appears in the upper abdomen and then moves to McBurney's point in the lower right abdomen. Chronic appendicitis, on the other hand, often lacks upper abdominal pain and initially presents with fixed discomfort or vague pain in the lower right abdomen. Only when chronic appendicitis acutely flares up does significant tenderness in the lower right abdomen occur, and rebound pain appears with peritonitis. Chronic appendicitis may also occasionally present with gastrointestinal symptoms such as nausea and vomiting.