Appendicitis location

Written by Zhang Peng
General Surgery
Updated on January 14, 2025
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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.

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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.

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Can appendicitis be contagious?

Appendicitis is a nonspecific inflammation occurring in the lumen of the appendix. It is not contagious, therefore, it is not an infectious disease. Once appendicitis is diagnosed, it is mostly treated surgically because the main blood supply to the appendix is the appendicular artery, which can easily lead to ischemic necrosis during inflammation. If controlled solely by medication, symptoms are likely to recur easily. Currently, appendectomy is commonly performed using minimally invasive techniques, under laparoscopy, which results in less bleeding during surgery and faster recovery afterward. Generally, if there is no suppuration or perforation, patients can be discharged three days after surgery. Postoperative care should be enhanced, including eating more vegetables to prevent constipation.

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Written by Ren Zheng Xin
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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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Is hot compress effective for appendicitis?

The effect of using heat therapy for appendicitis is relatively minor; it can be said that it does not have any significant effect. Appendicitis is caused by increased pressure in the lumen, ischemic necrosis of the mucous membrane, leading to inflammation. In most cases, this requires surgical removal of the appendix. Medication can only temporarily control the symptoms and it is prone to recurrence. Currently, laparoscopic appendectomy is a common surgical method for treating appendicitis. It is a minimally invasive treatment, with less bleeding during surgery and quicker post-operative recovery. Post-operative care is also important, including regular dressing changes for the incision. Stitches can usually be removed after about a week. It is advised to drink more water and eat more vegetables to prevent constipation. Patients should rest for at least two weeks after surgery to fully recover.

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Written by Ren Zheng Xin
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What should I do about acute appendicitis?

Once acute appendicitis is diagnosed and surgical contraindications are ruled out, appendectomy is usually performed. Currently, the most common method is laparoscopic appendectomy, which results in less intraoperative bleeding and quicker postoperative recovery. After the surgery, depending on the severity of the appendicitis, the use of antibiotics may be considered. Additionally, fasting is required on the day of the surgery, and a semi-liquid diet may be chosen for the first one or two days post-surgery. Three to four days after the surgery, foods like egg custard, vegetable soup, and rice can be eaten, before gradually transitioning back to a normal diet.