Appendicitis is the acute inflammation of the appendix, a small organ on the colon’s right side. The appendix is an extension of the intestine, found near the cecum in the right lower abdomen. While its precise function isn’t fully understood, it is believed to play a role in safeguarding the intestine from infection and is considered a vestigial process from herbivorous ancestors. Appendicitis is a prevalent condition affecting individuals of all ages, with a higher incidence among younger people. Left untreated, it can progress to bowel perforation, potentially leading to peritonitis. Recognizing the symptoms is crucial to prompt intervention and avoiding severe complications.

Common Symptoms of Appendicitis

  • Abdominal Pain: The pain often starts after a one- to two-day period of dyspeptic complaints, including poor appetite, headaches, and nausea. Initially, it may resemble colic-like pain, progressing to constant pain localized in the right lower part of the abdomen (right iliac fossa). Sometimes, the pain may radiate to the right thigh and lower back.
  • Nausea and Vomiting
  • Bowel Changes: Bowel movements may slow down, resulting in constipation and eventually leading to gas issues.
  • Fever: A mild fever, typically between 38-38.5°C, may also be present.

Causes of Appendicitis

The most common cause of appendicitis is the obstruction of the organ’s lumen, often due to:

  • Foreign Bodies: Such as coprolites (hardened fecal matter).
  • Angulation or Twisting of Viscera: While less common, this can lead to obstruction.

This obstruction creates an enclosed environment that encourages bacterial growth, elevating endoluminal pressure and causing stasis and ischemia. These conditions make it favorable for bacteria to invade the organ’s wall.

Diagnosis and Treatment

The diagnosis of appendicitis primarily relies on clinical evaluation and includes factors such as:

  • Pain Location
  • Muscle Rigidity
  • Nausea
  • Vomiting
  • Blood Test Results:

This often involves increased white blood cell count (leukocytosis) and C-reactive protein (CRP).

Diagnosis can be more challenging in atypical cases, where the appendix is located behind the colon (retrocecal) or the liver (subhepatic). An abdominal ultrasound followed by an abdominal CT scan may be necessary.