What is Appendicitis?
The appendix is a small outpouching of the colon. It is located at the Right Lower Quadrant (see picture below) of the abdomen.
Acute appendicitis simply means that there is a recent onset of an inflamed appendix.
Quickcare or ER
Appendicitis needs to go to the ER.
- severe abdominal pain
These symptoms are worrisome and need a good thorough work up with a surgeon available.
What will your doctor ask?
Your doctor will want to know your symptoms. Your symptoms are your description of your condition to your doctor. It is your story.
Answers to the following questions will help your doctor understand…
When did the abdominal pain start?
Where is the abdominal pain?
What made it better?
What made it worse ?
Do you have anything associated with it? ..such as fever, vomiting, lack of appetite
Classic appendicitis pain is local, sharp, constant pain in the right lower quadrant of the abdomen. It tends to be associated with fever, vomiting and lack of appetite
What will you doctor look for
Your doctor will look for signs. A sign is an objective finding that a doctor sees on exam.
A good abdominal exam is warranted. Press on all four quadrants (see photo above). Touching the belly is a vital part of your doctors understanding. Your doctor will want to know if there is tenderness or swollen masses. Is there any discoloration?
For boys, it is important to check the testicles. Remember, before boys are born, the testicles were in the abdomen. They gradually moved down into the scrotal sac. This means that there is a connection. Pain from the testicles can cause pain in the abdomen.
A doctor will poke in the spot between the navel and iliac spine. This is called “McBurney’s point.” Right lower abdominal pain at this spot is highly suggestive of appendicitis.
As part of an abdominal exam, your doctor will press on the left lower quadrant. If this causes pain over the appendix which is on the right lower quadrant, this is called Rovsing sign.
Confirmatory studies using an abdominal CT or ultrasound are generally requested before going to the Operating Room. For children, ultrasound has been and continues to be a reliable, non-radioactive diagnostic study.
What is your doctor thinking
Your doctor will come up with many reasons for pain. This list of the possibilities is called a differential diagnosis.
If the entire abdomen is distended and tender, it implies that the appendix may have burst. A perforated appendicitis has much more serious consequences as compared to one that has not burst.
Pain in McBurney’s point suggests appendicitis
Usually blood studies and a urine study will be done.
To confirm the diagnosis of appendicitis, an ultrasound may be done. This is great advancement since there is no radiation exposure to the younger children.
At times, however, a CT is needed.
What is the treatment of appendicitis
A surgical procedure called an appendectomy.
There are no magic pills for this.
The concern is if the appendicitis is not treated appropriately, then it will burst. This is a ruptured appendix. Pus then moves into the abdominal cavity causing a much more complicated treatment course.
Photo Credit: Drvgaikwad via Wikipedia
How long will you be sick?
After a surgery, there will be pain for a week or two. With the laproscopic techniques, which requires small incisions, recovery is less than before.
Let me tell you a story
Mario was always such a good boy. Never gave his mother a day of trouble. Never missed school. Perfect attendance from the 4th to 8th grade. Even when he fell and skid his knees, most boys would cry for Mamma. Mario? Gritted his teeth and slowly made his way, in a matter-of-fact way, inside the house for a simple bandage.
So when he woke his Mamma up in the middle of the night to tell her of his stomach hurting, she knew something was up.
Mario’s acute abdominal pain started the day before in the afternoon.
Mario pointed to his Right Lower Quadrant. (see picture)
“Doctor, when we were coming over here, I felt every bump on the road.”
In Mario’s case, he had a sharp, local, severe pain in the right lower quadrant of his abdomen. His pain got worse with movement He had an associated fever and anorexia (loss of appetite)
Being an inquisitive boy, Mario asked, “Why me? What did I do to make this happen?”
The answer is,”We don’t know…..We don’t even know why the appendix is there to begin with.”
After an uneventful laproscopic surgery, Mario went back to being the perfect child.
I hope this helps