How is acute appendicitis treated?

Written by Ren Zheng Xin
Gastroenterology
Updated on September 27, 2024
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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.

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Written by Ren Zheng Xin
Gastroenterology
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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.

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Precursors of acute appendicitis

Acute appendicitis is acute inflammation of the appendix lumen, and currently, there are no particularly typical precursors, but the causes of acute appendicitis should be noted, which are related to obstruction and infection of the appendix cavity. If the appendix lumen is compressed for a long time, the accumulation of secretions can cause blood supply disorders in the distal appendix wall, directly causing damage to the appendix mucosa, and inducing infection that leads to appendicitis. Additionally, gastrointestinal dysfunctions such as diarrhea and constipation can also cause spasms of the appendix muscles and vessels, leading to blood supply disorders and mucosal damage, thereby causing acute appendicitis.

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Gastroenterology
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Acute appendicitis complications

The main complications of acute appendicitis include: First, purulent peritonitis, due to the appendix becoming purulent and leading to perforation, pus flows into the abdominal cavity, causing diffuse peritonitis; Second, abdominal abscess, purulent appendicitis that is not treated surgically forms a capsule around the appendix, encapsulating it, and a lump can be felt on the abdominal surface; Third, internal-external fistula, if the abscess around the appendix is not drained in time, it can break through to the intestinal abdominal wall, forming a fistula.

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Gastroenterology
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How to medicate for acute appendicitis

Acute appendicitis is commonly treated surgically in clinical settings. Medication for acute appendicitis should be used with caution according to indications; if the appendix is not purulent, it is appropriate to use anti-inflammatory drugs to control the infection and choose sensitive antibiotics, such as quinolones. If the appendix becomes purulent or perforates, timely surgical treatment should be administered to prevent further exacerbation of appendicitis. Before and after the surgery, it is important to monitor whether the patient's symptoms and signs have significantly worsened. (Medications should be taken under the guidance of a physician and based on actual conditions)

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Written by Ren Zheng Xin
Gastroenterology
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Early symptoms of acute appendicitis

The symptoms of the early stage of acute appendicitis primarily include vague abdominal pain, initially across the abdomen, then transitioning around the belly button, and after several hours, shifting to the lower right abdomen where the pain becomes localized. The early symptoms of acute appendicitis are not typically distinctive, with the onset being quite sudden, accompanied by severe abdominal pain, vomiting, and fever. Based on these typical clinical manifestations, diagnosing acute appendicitis is not difficult. Clinically, the main treatment is the surgical removal of the appendix, with laparoscopic appendectomy being the more common practice nowadays. This method involves less bleeding during the operation and a quicker post-operative recovery.