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Appendicitis
Is appendicitis contagious?
Appendicitis is an inflammation that occurs in the lumen of the appendix, including acute appendicitis and chronic appendicitis. Appendicitis is not contagious, as it is not an infectious disease, but rather a purulent inflammation. Therefore, there is no need to isolate patients with appendicitis. Appendicitis usually requires surgical removal, but it is important to note that surgery should not be performed if acute appendicitis has been present for more than 72 hours, or if an abscess has formed. The majority of surgeries are performed using laparoscopic appendectomy, a method which allows for a faster recovery post-operation.
How is appendicitis surgery done?
Appendicitis currently primarily involves two surgical methods. One is appendectomy via laparoscopy, and the other is the traditional method involving an incision at McBurney's point to remove the appendix. While the surgical methods differ, the principle behind the surgery is the same: in the abdominal cavity, the appendix is separated from the mesentery, then the appendiceal artery is ligated and the appendix is removed from the base. The stump is disinfected with iodine, and purse-string sutures are used to wrap the stump. If there is an appendiceal perforation causing diffuse peritonitis, it is necessary to thoroughly clean the pus from the abdominal cavity, then check that no surgical instruments are left inside before closing the abdomen. Postoperatively, the use of antibiotic medication depends on the patient's condition, and a minimum rest period of two weeks is required. (The use of medications should be under the guidance of a doctor.)
Causes of Appendicitis
The appendix is connected to the cecum at one end, has a narrow lumen, and is rich in lymphatic tissue. The anatomical basis of the appendix makes it prone to inflammation. Generally, appendicitis is caused by different obstructions in the appendix, such as fecaliths, fecal masses, food residues, and parasites like roundworms, which can all lead to obstruction of the appendix and trigger acute appendicitis. Additionally, gastrointestinal dysfunction can also cause spasms and contractions of the muscles in the appendix wall, affecting the emptying of the appendix and its blood circulation, leading to inflammation of the appendix. Appendicitis requires timely treatment, and surgery might be necessary for symptomatic support.
How to diagnose appendicitis
Appendicitis is primarily diagnosed clinically through a physical examination. The patient is asked to lie flat, exposing the abdomen, with legs bent. The doctor stands on the patient’s right side and uses the right hand with fingers together to gently rub the abdomen, pressing on the McBurney's point. If there is significant pain, this is considered positive tenderness. Then, the doctor quickly lifts the fingers; if there is significant rebound pain, it is generally confirmed as acute appendicitis. During acute appendicitis, as the appendix lumen expands and the appendix becomes congested and edematous, ultrasound imaging can also show corresponding signs that serve as an auxiliary diagnosis. Once acute appendicitis is confirmed, it is mostly treated surgically.
How long after appendicitis can one have intercourse?
Regarding how long after appendectomy one can engage in sexual activities, it mainly depends on the treatment method used and the healing status after the surgery. Most cases of appendicitis can be treated with minimally invasive techniques, which not only cause less trauma and allow for quicker recovery but also reduce postoperative complications. The abdomen typically has two to three small puncture holes, each about one centimeter in length, and most patients can achieve sufficient strength to engage in sexual activities about a month after surgery. However, for traditional open surgery, the abdominal incision is usually longer, which may lead to incision infection and poor healing of the incision, and it generally takes about three months to achieve sufficient strength. For acute appendicitis, minimally invasive treatment is generally recommended, provided the patient's condition permits.
Where does chronic appendicitis hurt?
Chronic appendicitis, unlike acute appendicitis, does not begin with upper abdominal pain followed by pain in the lower right abdomen, which we refer to as migratory lower right abdominal pain; migratory lower right abdominal pain is a characteristic symptom of acute appendicitis. Chronic appendicitis typically presents with chronic recurrent pain, discomfort, dull pain, or bloating in the lower right abdomen. During a physical examination, chronic appendicitis generally manifests as fixed tenderness in the lower right abdomen, with less evident rebound pain. Rebound pain in the lower right abdomen during a physical exam only occurs when chronic appendicitis acutely flares up and signs of peritonitis are present.
How to relieve pain from acute appendicitis
For rapid pain relief in acute appendicitis, one can choose antispasmodic or sedative medications. However, it is important to note that acute appendicitis often requires surgical treatment clinically. If the pain is not particularly severe, conservative medication treatment can also be chosen, using sensitive antibiotics for anti-inflammatory pain relief. If surgery involves appendectomy, laparoscopic appendectomy is generally chosen, which has less intraoperative bleeding and quicker postoperative recovery. Only after the appendix is removed can the onset of acute appendicitis be effectively controlled or the transition from acute to chronic appendicitis prevented. (Specific medications should be used under the guidance of a physician.)
Can appendicitis recur?
Acute appendicitis, if not treated surgically, can relapse under poor lifestyle and dietary habits and then transform into chronic appendicitis. Therefore, appendicitis can recur. However, if the appendix is removed during an acute episode of appendicitis, then appendicitis will not recur. Currently, the primary clinical treatment for appendicitis is surgery, because without surgery, the recurrence rate of appendicitis is quite high, and ultimately, the appendix must be removed.
Can appendicitis cause a fever?
Appendicitis can cause fever. After the fever, a routine blood test will show a significant increase in white blood cells, which is often referred to as an elevated blood profile. In addition to fever, appendicitis may also cause vomiting and nausea. A typical symptom is abdominal pain, starting around the navel and then gradually moving to the lower right abdomen. For the fever, active symptomatic fever reduction should be pursued, or appendectomy can be chosen. Currently, laparoscopic appendectomy is more common, with less bleeding during the operation and faster post-operative recovery.
Appendicitis location
The location of appendicitis is generally in the lower right abdomen, as the appendix is mostly located in the right iliac fossa. There are very few cases of situs inversus, where it is located on the left, but the appendix usually originates from the base of the cecum, attached to the posterior wall of the cecum, at the confluence of the three taeniae coli. Therefore, the surface projection of the appendix is mostly at the junction of the outer one-third of the line connecting the navel and the right anterior superior iliac spine, which is also commonly used as the marking point for surgical incisions. In cases of appendicitis, there may be pain in the upper right abdomen or pelvic region due to changes in the position of the appendix. For confirmed diagnoses of appendicitis, surgery is generally considered, and minimally invasive methods can be chosen. If an abscess forms around the appendix and the patient's condition can be managed, conservative treatment is usually preferred initially, followed by elective removal of the appendix after three months.