Appendicitis

Appendicitis is an inflammation and infection of the appendix – a small, finger shaped sac of tissue that is located in the first part of the colon, typically in the lower-right abdomen. If an inflamed appendix ruptures, it may release dangerous bacteria into your abdomen, causing a serious condition called peritonitis.

There is some debate about the importance of the appendix in the human digestive system. Though it has been widely regarded as a vestigial – or non-essential – organ, new research suggests it may play a role in preserving essential “gut” bacteria when illness flushes bad bacteria from the intestines.

Although appendicitis can be life-threatening, an appendectomy (surgical removal of the appendix) is a common emergency surgery.

The skilled, board-certified general surgeons affiliated with Memorial Hermann specialize in abdominal surgeries. So, if an appendectomy is necessary for yourself or a loved one, you can rest assured you’re in the hands of experienced surgeons.

Appendicitis occurs when the appendix becomes blocked, often by impacted stool, a foreign body or cancer. This condition can have multiple causes. In many cases, those causes are unclear, but a few possibilities include:

• Inflammation of the appendix due to infection of the gastrointestinal (GI) tract
• Inflammatory bowel disease
• Pelvic inflammatory disease
• Swelling of the appendix in response to other bacterial infections in the body
• General abdominal trauma

Appendicitis is the most common cause of acute abdominal pain requiring surgery. While anyone can develop the condition, it most often occurs in those between the ages of 10 and 30. According to the World Journal of Gastroenterology, men have a lifetime risk of 8.6% and women 6.7%. In the U.S., over 5% of the population eventually develops appendicitis.

When caught early, appendicitis has a very high success rate for treatment, so it’s important to recognize early signs and symptoms of inflammation, which may include:

• Pain localized to the right side of the abdomen, often originating around the navel and moving to the lower right side of the abdomen
• Pain that worsens with jarring movement, walking or coughing
• Loss of appetite
• Nausea or vomiting
• Fever
• Constipation or diarrhea
• Abdominal bloating

Difficulty passing gas due to a partial or complete bowel obstruction is another possible sign of underlying appendicitis.

Peritonitis related to a ruptured appendix is a life-threatening condition. Though rupture rarely occurs within 24 hours of the onset of symptoms, the risk greatly increases after 48 hours. If you or a loved one begins to exhibit any of the symptoms listed above, seek immediate emergency medical attention by calling 911 or visiting an Emergency Room.

If appendicitis is suspected, your doctor will take a history of your symptoms and examine your abdomen, applying gentle pressure to the area of pain.

During the examination, be prepared to answer the following questions:

• When did your abdominal pain begin?
• What is the exact location and severity of your pain?
• When did you begin to notice other symptoms besides pain?
• What other medical conditions, previous illnesses and surgical procedures have you had in the past?
• Do you take any specific medicines, or use alcohol or illegal drugs?

Your doctor may also order further tests in order to confirm a diagnosis of appendicitis, including:

• Blood tests to check for a high white blood cell count, which could indicate infection
• Urinalysis to rule out a urinary tract infection or the presence of a kidney stone
• Imaging tests including MRI, abdominal X-ray or ultrasound to confirm the diagnosis and/or detect other sources of pain

The standard treatment for appendicitis is surgical removal of the appendix, called an appendectomy. The skilled, general surgeons affiliated with Memorial Hermann specialize in performing laparoscopy and other minimally invasive surgical procedures to treat appendicitis.

Laparoscopy Appendectomy

During a laparoscopic appendectomy, a few small incisions are made in the abdomen and a tiny camera, called a laparoscope, is inserted. The laparoscope is used to see inside the abdomen while manipulating special instruments to surgically remove the appendix and suture the wound.

Laparoscopic surgery is preferred by most surgeons and patients for treating appendicitis, as it can often result in fewer complications, smaller scars and a shorter recovery time.

Open Appendectomy

On the other hand, an open appendectomy may be necessary if a patient’s appendix has ruptured, if the triggering infection has spread beyond the appendix, or if there is the presence of an intestinal abscess.

During an open appendectomy, a large incision will be made on the lower right side of the abdomen. This allows enough space to remove the ruptured appendix and clean out any harmful bacteria remaining in the abdominal cavity. The incision is then stitched back together.

If you undergo an appendectomy, the staff at Memorial Hermann will observe your vital signs for a period of time after the surgery, before allowing you to be released. If you undergo an early-stage appendectomy to remove an appendix that has not yet ruptured, you will most likely go home within a day or two. However, if your appendix has ruptured, you may need to stay in the hospital for up to a week in order to ensure there is no post-operative infection.

General abdominal pain is not abnormal, but depending on the location and intensity of the pain, it could be a sign of something more serious like appendicitis. If you’re unsure about the source of your pain, your best bet is to get checked out by a trained specialist to ensure you’re not putting yourself in danger.

If you believe you may have appendicitis, or worse, your appendix may have burst, seek medical attention immediately.

For all other cases of general abdominal pain, schedule an appointment today with a Memorial Hermann-affiliated physician using our online ScheduleNow portal or by calling (713) 222-CARE.