The Difference Between Acute and Chronic Appendicitis

Written by Ren Zheng Xin
Gastroenterology
Updated on September 05, 2024
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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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How is acute appendicitis treated?

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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Does acute appendicitis cause vomiting?

Acute appendicitis can cause vomiting due to inflammation stimulating spasms in the gastrointestinal tract. In addition to vomiting, another typical symptom is abdominal pain, which starts around the navel and shifts to the lower right abdomen, and it is more commonly fixed in the lower right abdomen. The inflammation entering the bloodstream also causes fever, generally not exceeding 38.5°C. If there is significant pus formation or appendix perforation, it can cause high fever. The treatment primarily involves surgical removal of the appendix, with laparoscopic appendix removal being commonly used nowadays. This surgical method has less bleeding during the operation and a faster recovery afterward.

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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.

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Gastroenterology
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Symptoms of acute appendicitis

The typical symptoms of acute appendicitis include abdominal pain that starts around the upper abdomen or navel area, then localizes to the lower right abdomen. There are also manifestations of gastrointestinal spasms such as nausea and vomiting. Due to inflammation entering the bloodstream, there can be a systemic infection, often accompanied by fever, generally not exceeding 38 degrees Celsius. If there is an appendix perforation and peritonitis, the temperature can exceed 38 degrees. After the appendix becomes suppurative, symptoms can include abdominal muscle rigidity, dental pain, and rebound tenderness.

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Written by Ren Zheng Xin
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.