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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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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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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Written by Ren Zheng Xin
Gastroenterology
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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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Written by Li Jin Quan
General Surgery
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The difference between chronic appendicitis and acute appendicitis

The difference between chronic appendicitis and acute appendicitis is that most cases of chronic appendicitis are formed after the treatment of acute appendicitis. Chronic appendicitis and acute appendicitis display different symptoms. Acute appendicitis has typical migratory pain in the lower right abdomen, which initially appears in the upper abdomen and then moves to McBurney's point in the lower right abdomen. Chronic appendicitis, on the other hand, often lacks upper abdominal pain and initially presents with fixed discomfort or vague pain in the lower right abdomen. Only when chronic appendicitis acutely flares up does significant tenderness in the lower right abdomen occur, and rebound pain appears with peritonitis. Chronic appendicitis may also occasionally present with gastrointestinal symptoms such as nausea and vomiting.

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Written by Ren Zheng Xin
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.