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Appendicitis

Appendicitis is a condition characterised by inflammation of the appendix.

Causes

It is possible for matter to become lodged in the appendix, leading to bacterial infection, which can cause appendicitis. If the condition is untreated, the appendix can turn gangrenous and can eventually burst, leading to peritonitis, septicemia and eventually death.

Signs, symptoms and examination findings

The pain of appendicitis usually starts centrally before localising to the right iliac fossa (the lower right side of the abdomen). There is usually associated anorexia (loss of appetite). Nausea, vomiting and diarrhea may or may not occur. Fever is usually present.

There is typically pain and tenderness in the right iliac fossa. Rebound tenderness may be present suggesting that there is some element of peritoneal irritation. If the abdomen is guarded, there should be a strong suspicion of peritonitis and an urgent operation should be kept in mind.

Diagnosis

Diagnosis is based on history and physical examination backed by blood tests and other diagnostic procedures.
A standard test for appendicitis when abdominal pain is present is maximum tenderness at McBurney's point, which is located on the righthand side one-third of the distance between the hipbone and the navel, or approximately one hand's width.

Treatment

Appendicitis can be treated by removal of the appendix through a surgical procedure called an appendicectomy, or, more commonly, an appendectomy.

Antibiotics are given intravenously to help kill remaining bacteria.

Prognosis

Most appendicitis patients recover easily with treatment, but complications can occur if treatment is delayed or if peritonitis occurs secondary to a perforated appendix.

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See also: Gastroenterology