This Is What You Should Know About Acute Appendicitis (Inflammation Of The Appendix)

The appendix is a blind-ended tube connected to the caecum which is located at the junction of the small and the large intestines.
Acute inflammation of the appendix is called ‘Acute Appendicitis’. 

Written by Mr Panduka Jayawardena on 30.5.2021

Medically Reviewed by Dr. K. on 31.5.2021

The Appendix

The appendix is a blind ended tube connected to the caecum which is located at the junction of the small and the large intestines.
Acute inflammation of the appendix is called ‘Acute Appendicitis’. This is one of the most common abdominal emergencies in the world (1). If left untreated, appendicitis can lead to complications such as abscess, appendicular mass (when the omentum wraps around the appendix), gangrene and perforation (2).

Causes of Acute Appendicitis

Acute appendicitis is most common between ages 10 and 30 years and slightly more common in men. (1)

Exact cause of acute appendicitis is unknown. However, one of the common theories is the obstruction of the lumen of the appendix typically by fecalith, lymphoid, hyperplasia or impacted stool. Luminal obstruction will lead to distension of the appendix and bacterial overgrowth. (1)

Symptoms of Acute Appendicitis

Almost all patients with acute appendicitis will present with a short history of constant abdominal pain, classically pain begins in the central abdomen and migrates to the right lower quadrant of the abdomen. Some may develop nausea or vomiting, loose stool, loss of appetite and a low grade fever. (3)

Treatment of Acute Appendicitis

Appendectomy is recommended as the treatment of choice for acute appendicectomy (appendectomy).

Laparoscopic (key hole) appendectomy is associated with lower morbidity and mortality. If there are no complications, antibiotics could be stopped following the appendectomy.

In severe appendicitis or complicated appendicitis, the patient may need to take a course of oral or intravenous antibiotics following the surgery.

Antibiotic treatment without surgery can successfully treat acute uncomplicated appendicitis in some adults but is associated with increased risk of recurrence. (4)

Source:

Referenced on 30.5.2021

  1. Bhangu A, Søreide K, Di Saverio S, Assarsson JH, Drake FT. Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management. Lancet. 2015 Sep 26;386(10000):1278-87
  2. Flum DR. Clinical practice. Acute appendicitis–appendectomy or the “antibiotics first" strategy. N Engl J Med. 2015 May 14;372(20):1937-43
  3. Petroianu A. Diagnosis of acute appendicitis. Int J Surg. 2012;10(3):115-9
  4. Lundholm K, Hansson-Assarsson J, Engström C, Iresjö BM. Long-Term Results Following Antibiotic Treatment of Acute Appendicitis in Adults. World J Surg. 2017;41(9):2245-2250. doi:10.1007/s00268-017-3987-6

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