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Appendicitis
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Appendicitis is an inflammation of the vermiform appendix, a finger-like appendage to the cecum, the first part of the large intestine. The inflammation results from a bacterial infection that causes the appendix to swell and fill with pus. An early symptom of appendicitis is intermittent pain in the navel region. This becomes more severe and, within hours, localizes to the lower, right-hand corner of the abdomen. The abdominal muscles tighten, and the person loses his or her appetite and becomes nauseated. A slight fever is usual, as is constipation.
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Appendicitis is inflammation of the appendix, a small pouch attached to the cecum, the beginning of the colon, on the lower right side of the abdomen. The appendix is not necessary for life, but it can become diseased. If untreated, an inflamed appendix can burst, causing infection and even death. Appendicitis can affect people at any age. It is most common in people ages 10 to 30.
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Appendicitis means inflammation of the appendix. It is thought that appendicitis begins when the opening from the appendix into the cecum becomes blocked. The blockage may be due to a build-up of thick mucus within the appendix or to stool that enters the appendix from the cecum. The mucus or stool hardens, becomes rock-like, and blocks the opening. This rock is called a fecalith (literally, a rock of stool). At other times, the lymphatic tissue in the appendix may swell and block the appendix.
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Appendicitis occurs when the interior of the appendix becomes filled with something that causes it to swell, such as mucus, stool, or parasites. The appendix then becomes irritated and inflamed. The blood supply to the appendix is cut off as the swelling and irritation increase. Adequate blood flow is necessary for a body part to remain healthy. When the blood flow is reduced, the appendix starts to die. Rupture (or perforation) occurs as holes develop in the walls of the appendix, allowing stool, mucus, and other substances to leak through and get inside the abdomen.
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Appendicitis can be classified into two types, typical and atypical. The pain of typical acute appendicitis usually starts centrally (periumbilical) before localising to the right iliac fossa (the lower right side of the abdomen). There is usually associated loss of appetite and fever. Nausea, or vomiting may or may not occur. These classic signs and symptoms are the least painful way to localize the area of peritonitis. If the abdomen is involuntarily guarded (rigid), there should be a strong suspicion of peritonitis requiring urgent surgical intervention.
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Appendicitis diagnosis issues in females. Appendicitis diagnostic errors are far more common in females than in males. For example, the misdiagnosis of women of reproductive age (aged 14 to 49) for unnecessary appendicitis surgery can range from 20% to 45% (Morse et al., 2007 Am Surg vol 73, no 6: pp 580-4). In the AspenBio study, there were a total of 198 evaluable female patients, of which 42 had pathology confirmed appendicitis. The AppyScore screen test identified 41/42 (98%) of these pathology-confirmed appendicitis cases. There were 109 female patients 30 years of age and younger out of the 198 evaluable female patients.
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Appendicitis