What is acute appendicitis?

Written by Ren Zheng Xin
Gastroenterology
Updated on September 14, 2024
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Acute appendicitis refers to the acute inflammation occurring in the lumen of the appendix, which is caused by the narrowing or blockage and subsequent infection of the lumen. The primary symptom is abdominal tenderness and rebound pain, accompanied by nausea, vomiting, and fever. During the acute phase, blood tests often show an elevated white blood cell count. The main treatment is surgical removal of the appendix, with laparoscopic appendectomy being the commonly used method. This is also a minimally invasive approach to appendicitis treatment. Postoperative care is important, and it is advised to fast on the day of the surgery. Once gas passes through the rectum, a liquid diet may be resumed.

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Written by Ren Zheng Xin
Gastroenterology
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Causes of Acute Appendicitis

The main causes of acute appendicitis are obstruction of the appendiceal lumen and concurrent infection. The appendiceal lumen is a narrow tube that communicates with the cecum at one end. Obstruction, such as a fecalith, can lead to increased pressure inside the lumen, disturbances in blood flow, damage to the mucosa, and secondary infection. It can also be caused by direct bacterial infection within the appendiceal lumen, leading to acute inflammation. Additionally, repeated diarrhea or constipation and other gastrointestinal dysfunctions can also cause circulation disturbances in the appendix, leading to bacterial invasion and acute inflammation.

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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 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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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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Written by Ren Zheng Xin
Gastroenterology
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Typical symptoms of acute appendicitis

The typical symptoms of acute appendicitis include abdominal pain, which starts in the upper abdomen or around the navel and, after several hours, shifts and localizes to the lower right abdomen. Additionally, reflexive gastric spasms may cause nausea and vomiting. Due to the inflammation, the body may develop a fever, generally not exceeding 38 degrees Celsius. If the inflammation affects the parietal peritoneum, it can cause tenderness, rebound pain, and abdominal muscle rigidity. These are the typical symptoms, and a preliminary diagnosis can usually be made based on them. Most cases require an appendectomy.