acute appendicitis symptoms

Written by Ren Zheng Xin
Gastroenterology
Updated on September 28, 2024
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The symptoms of acute appendicitis typically include abdominal pain at the onset of the condition, which initially occurs around the navel and then localizes to the lower right abdomen, as well as early nausea and vomiting caused by gastric spasms. Patients with more severe inflammation may also exhibit fever. If the inflammation spreads to the peritoneum, there will be tenderness at McBurney's point and rebound tenderness, along with tense abdominal muscles. Based on these symptoms, making a definitive diagnosis of acute appendicitis is not particularly difficult.

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Written by Ren Zheng Xin
Gastroenterology
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The Difference Between Acute and Chronic Appendicitis

The differences between acute appendicitis and chronic appendicitis mainly lie in the onset of the condition, physical signs, and laboratory tests. First, regarding the onset of the condition, acute appendicitis occurs suddenly and can involve abrupt abdominal pain, whereas chronic appendicitis often manifests as fixed tenderness in the lower right abdomen and the symptoms are not particularly typical. In terms of physical signs, acute appendicitis presents with migratory pain in the lower right abdomen, while chronic appendicitis generally does not involve rebound pain. Thirdly, concerning auxiliary examinations, acute appendicitis shows a significant increase in the white blood cell count during an attack, whereas in chronic appendicitis, the white blood cell count may appear normal.

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Written by Ren Zheng Xin
Gastroenterology
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The cause of acute appendicitis

The etiology of acute appendicitis is directly related to obstruction and infection of the appendiceal lumen. The appendix, a narrow and elongated tube connected to the cecum, can develop increased luminal pressure due to obstruction, leading to disturbances in the blood supply to the appendiceal wall. This can easily cause damage to the mucosa and subsequent infection. Infection of the appendiceal lumen can directly cause acute appendicitis. Additionally, gastrointestinal dysfunction can also cause muscle and vascular spasms in the appendix leading to blood supply disturbances and the invasion of bacteria, resulting in acute inflammation. For acute appendicitis, surgical treatment should be administered immediately upon diagnosis.

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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.

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Gastroenterology
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How is acute appendicitis diagnosed?

The definitive diagnosis of acute appendicitis is primarily through clinical physical examination and auxiliary tests. Based on typical symptoms of acute appendicitis, such as migratory right lower abdominal pain, vomiting, nausea, fever, and a few patients may have symptoms of constipation or diarrhea. There is obvious tenderness and rebound pain when pressing on the abdomen. Additionally, an abdominal ultrasound can indicate swelling of the appendix lumen and a significant increase in appendix size. These aspects can lead to a preliminary diagnosis, and once acute appendicitis is confirmed, surgical treatment should be carried out.

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Written by Ren Zheng Xin
Gastroenterology
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Causes of Acute Appendicitis

The causes of acute appendicitis mainly include two types: one is the obstruction of the appendiceal lumen, and the other is infection within the appendiceal lumen. The appendix is a tube that communicates with the cecum. If it is blocked by fecoliths or fecal masses, it can lead to increased pressure inside the appendiceal lumen, damage to the mucosa, and bacterial invasion causing infection, which directly leads to acute inflammation. At the same time, gastrointestinal dysfunction can also cause spasm of appendix muscles and blood vessels, leading to blood supply disturbances. Irregular lifestyle habits, overeating, and engaging in vigorous activities after meals can all trigger acute appendicitis.