What should I do about chronic appendicitis?

Written by Li Jin Quan

General Surgery

Updated on February 28, 2025

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Most cases of chronic appendicitis are transformed from treated acute appendicitis. Clinically, chronic appendicitis mainly presents as recurrent pain or dull pain in the lower right abdomen. When diagnosed with chronic appendicitis, active surgical treatment is recommended. Currently, the surgical options include traditional open appendectomy and laparoscopic appendectomy, which is referred to as minimally invasive surgery. Minimally invasive surgery causes less trauma and allows for quicker recovery.

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Written by Ren Zheng Xin

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What are the symptoms of appendicitis?

Appendicitis is an acute inflammation occurring in the lumen of the appendix. The primary symptoms include fever, nausea, vomiting, abdominal tenderness, and rebound pain. Migratory right lower abdominal pain is a common indicator used for diagnosing appendicitis. Additionally, appendicitis located posterior to the peritoneum may also present with radiating pain in the lower back. Once appendicitis is diagnosed, surgical treatment is required, except for elderly or frail individuals who cannot tolerate surgery and may opt for conservative treatment. Laparoscopic appendectomy is a commonly used surgical method, as it involves less bleeding during surgery and faster recovery afterwards. Postoperative care should be emphasized, with adjustments in diet, and an increased intake of vegetables to prevent constipation.

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Can appendicitis cause vomiting?

Some patients with appendicitis may experience symptoms such as nausea and vomiting. This is because the appendix is located in the lower right abdomen near the ileocecal area, and the appendix cavity is connected to the cecum. The appendix is an independent organ of the human digestive tract. When inflamed, the inflammation can easily irritate the surrounding intestines, causing intestinal spasms and contractions, leading to nausea and vomiting. A typical manifestation of appendicitis is referred pain in the lower right abdomen. Once appendicitis is diagnosed, it is advisable to promptly start anti-inflammatory treatment and, if necessary, proceed with surgical treatment. Appendicitis can range from acute simple appendicitis, which responds well to conservative anti-inflammatory treatment, to acute suppurative or even perforated appendicitis. In these severe cases, it is recommended to perform surgery as soon as possible to remove the appendix and clear the inflammatory secretions, alongside anti-inflammatory treatment.

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Written by Zhang Peng

General Surgery

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Appendicitis belongs to which department?

Appendicitis falls under the domain of general surgery, and its pathological changes can be categorized into several types. The first type is acute simple appendicitis, characterized by mucosal congestion and edema, with patients typically presenting mild symptoms. The second type is acute suppurative appendicitis, also known as cellulitis, where symptoms worsen, and patients may develop fever and experience tenderness and rebound pain in the lower right abdomen. The third type includes acute gangrenous and perforative appendicitis, where the condition further worsens. The appendix wall is necrotic or partially necrotic, and perforation usually occurs at the proximal end of the appendix, potentially leading to the formation of a periappendiceal abscess. If the perforation extends into the abdominal cavity, it can lead to diffuse peritonitis, often requiring emergency surgical exploration. The fourth type involves a periappendiceal abscess, typically progressing slowly. The omentum can move to the lower right side and envelop the appendix, forming adhesions and leading to the formation of an abscess. Most cases are treated conservatively, and traditional Chinese medicine is used adjunctively to promote the absorption of the abscess.

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Gastroenterology

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What department should I go to for appendicitis?

Appendicitis is a common disease in general surgery, so one can register for a general surgery appointment. In clinical practice, the diagnosis of appendicitis is mainly based on clinical manifestations. Typical symptoms include abdominal pain, vomiting, and fever. The abdominal pain starts around the navel and then moves to the lower right abdomen after several hours, where the pain becomes localized. Once diagnosed with appendicitis, surgery is often required. Currently, laparoscopic appendectomy is commonly used. This surgical method requires general anesthesia and is relatively complex, but recovery is quicker, and patients typically can be discharged after a routine 3-day hospital stay.

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Acute appendicitis pain is on that side.

In the initial stages of acute appendicitis, pain can occur in the left side of the abdomen, then gradually move around the navel, and eventually becomes fixed in the lower right abdomen. The typical symptom of appendicitis is migratory pain in the lower right abdomen, which becomes severe upon pressing and intensifies when lifted, a phenomenon known as rebound tenderness. A small number of patients may experience pain in the lumbar and back areas, which could be due to inflammation caused by a retroperitoneal position. Based on the typical symptoms of appendicitis, a diagnosis cannot be confirmed. After confirmation, most cases require an appendectomy.