How to diagnose appendicitis

Written by Ren Zheng Xin
Gastroenterology
Updated on January 22, 2025
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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.

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Written by Ren Zheng Xin
Gastroenterology
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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.

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Written by Ren Zheng Xin
Gastroenterology
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What can you eat with appendicitis?

The diet for appendicitis should be based on the needs of the condition, determining what can or cannot be eaten based on the response of the gastrointestinal tract. During the acute inflammatory phase, fasting is necessary, and hydration and electrolytes should be replenished through intravenous fluids. If the inflammation is severe, immediate surgical treatment should be undertaken. For chronic appendicitis, soft and easily digestible foods can be consumed, and proactive anti-inflammatory or surgical treatments should be pursued. Post-surgery, it is important to rest in bed and use anti-infection medications timely to prevent infections.

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Written by Ren Zheng Xin
Gastroenterology
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Does appendicitis cause fever?

Appendicitis often causes fever, due to systemic infection caused by inflammation entering the bloodstream. Generally, it only causes a low fever without chills. The temperature in suppurative appendicitis does not exceed 38 degrees Celsius. High fever above 38 degrees Celsius is mostly seen in cases of appendiceal perforation or concurrent peritonitis. In addition to fever, acute appendicitis also presents with abdominal pain, tenderness and rebound pain in the abdomen, tension in the abdominal muscles, as well as nausea, vomiting, and increased frequency of bowel movements due to reflexive gastric spasms.

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Written by Ren Zheng Xin
Gastroenterology
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Does appendicitis surgery require an incision?

Appendicitis surgery can be performed through traditional open surgery or minimally invasive treatment. Open surgery involves a traditional incision at McBurney's point to remove the appendix, which is now rarely used, predominantly replaced by minimally invasive treatment under laparoscopy. The procedure is the same for both methods, involving ligation of the appendicular artery followed by cutting the appendix at its base and suturing the stump. The advantages of minimally invasive surgery include less intraoperative bleeding, faster postoperative recovery, and less physical trauma. Patients can choose between open surgery or minimally invasive treatment based on their personal circumstances and financial conditions.

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Written by Ren Zheng Xin
Gastroenterology
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Appendicitis pain location

Appendicitis initially presents with pain throughout the abdomen and around the navel, which gradually shifts to the lower right abdomen, and the pain becomes more localized. Besides abdominal pain, symptoms of appendicitis can also include nausea, vomiting, and fever. Most cases of appendicitis require surgical treatment. Currently, laparoscopic appendectomy is a common surgical method. This technique involves less bleeding during surgery, quicker postoperative recovery, and minimal scarring. If one cannot tolerate general anesthesia, an option is to remove the appendix through an incision at McBurney's point.