Appendicitis

Inflammation of the appendix (appendicitis) is a condition that causes acute abdominal pain. 

Causes
Although the exact cause is often unknown, most cases are likely to be due to an obstruction in the appendix due to feces. Bacteria are very numerous in the feces, and so can multiply behind the obstruction, leading to infection and subsequent inflammation.

Signs and Symptoms
The most common symptom is abdominal pain. This often begins as central abdominal pain, and then moves to the lower right hand side. Nausea and vomiting is common. There may be a fever, although fever is not always present, especially not in the early stages of the illness.

Investigations
The diagnosis is made from taking a thorough history and physical examination. Ultrasound examination or CT scan may assist in making the diagnosis.

Other causes of abdominal pain must also be considered, such as urinary tract infection, pregnancy, or gynecological conditions.

Treatment
Intravenous fluids must be given as required. Intravenous antibiotics may be the treatment of choice for patients with uncomplicated appendicitis. Analgesia must be given as required.

The concern is that the inflamed appendix might swell up and perforate, causing the contents of the intestine to spill into the abdomen. This would cause a serious infection. Therefore, if there are concerns that the appendix might perforate then surgery is advised to remove the appendix (appendicectomy). Preoperative antibiotics are recommended.