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Appendicitis: Symptoms
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Appendicitis is a common and urgent surgical illness with protean manifestations, generous overlap with other clinical syndromes, and significant morbidity, which increases with diagnostic delay. No single sign, symptom, or diagnostic test accurately confirms the diagnosis of appendiceal inflammation in all cases.
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Appendicitis can be a challenging condition to diagnose correctly. There are many other conditions that can cause similar symptoms, such as urinary tract infections (UTIs), and gastroenteritis (an infection of the stomach.)
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Appendicitis can mimic the symptoms of other disorders such as gastroenteritis, ectopic pregnancy and various infections (including those of the kidney and chest). Diagnosis methods may include a thorough physical examination and careful consideration of the symptoms. If the diagnosis is not clear, then laboratory tests and ultrasound or CT scans may be needed. Since appendicitis is potentially life threatening if left untreated, doctors will err on the side of caution and operate, even if there is no firm diagnosis.
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The treatment for sudden, severe appendicitis is surgery to remove the appendix, called an appendectomy. An appendectomy may be done by opening the abdomen in the standard operating technique, or through laparoscopy, in which a small incision is made through the navel. Recovery may be faster with a laparoscopy than with an ordinary appendectomy. An appendectomy should be performed within 48 hours of the first appearance of symptoms, to avoid a rupture of the appendix and peritonitis. Antibiotics are given before surgery in case peritonitis has already taken hold. If peritonitis is discovered, the abdomen must ... be irrigated and drained of pus, and then treated with multiple antibiotics for 7-14 days.
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Because of the risk of rupture, appendicitis is considered an emergency. If you are experiencing symptoms of appendicitis, you should go to an emergency room. The doctor will ask about your symptoms and your medical history, conduct a physical exam to check for abdominal tenderness, and may order blood tests and urine tests. Some health care providers use ultrasound to check whether the appendix is inflamed (and to rule out ovarian cysts or ectopic pregnancy in women). A computed tomography (CT) scan may ... be performed.
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The diagnosis of appendicitis can usually be made by examining your child and discussing their symptoms. Blood tests, an ultrasound or other investigations may be done if the diagnosis is less certain. A period of observations in hospital is often more useful that tests. The diagnosis can be more difficult in younger children. Sometimes, the diagnosis isn't suspected until the appendix has ruptured. In a small number of cases, the diagnosis is suspected but the symptoms prove to have another cause.
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