The cause of acute appendicitis

Written by Ren Zheng Xin
Gastroenterology
Updated on September 02, 2024
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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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Written by Ren Zheng Xin
Gastroenterology
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Which is more serious, acute appendicitis or chronic appendicitis?

The symptoms of acute appendicitis are relatively more severe because acute suppurative appendicititis can cause perforation of the appendiceal lumen. After the perforation, pus can flow into the abdominal cavity causing diffuse peritonitis, leading to abdominal muscle tension, tenderness, and rebound pain. If not treated promptly, it can lead to multiple organ failure. Chronic appendicitis is mostly due to incomplete treatment of acute appendicitis, or chronic latent appendicitis. The symptoms of chronic appendicitis are sometimes mild and the physical signs are not definite. Surgical removal of the appendix should be the first choice for treating acute appendicitis.

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Anesthesia methods for acute appendicitis

The anesthesia method for acute appendicitis is related to the type of surgical treatment. If laparoscopic appendectomy is chosen, general anesthesia is usually required. If a traditional McBurney point incision is used for appendectomy, spinal anesthesia is primarily chosen. Additionally, after anesthesia, gastrointestinal function will be somewhat restricted. Until there is no gas or bowel movement from the rectum, patients should not eat after surgery. Only when the rectum starts to pass gas, indicating that gastrointestinal function is beginning to recover, can the patient begin to consume soft foods.

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Gastroenterology
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acute appendicitis symptoms

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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How is acute appendicitis treated?

Acute appendicitis treatment primarily involves surgical methods, where the inflamed, suppurative, or perforated appendix is excised during the procedure, and then the base of the appendix is sutured. Moreover, if there is suppuration, it is necessary to irrigate the peritoneal cavity to prevent intra-abdominal infections. After the surgery, fluid therapy should be administered based on the patient's condition. In cases of perforation or suppuration, antibiotics should be used post-operatively. For simple appendicitis, post-operative fluid replenishment is generally sufficient, and antibiotics are not required. (Please use medications under the guidance of a doctor.)

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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.