What Is Appendicitis



The appendix is a small, dead-end pouch, situated just below the point where the small intestine empties into the large; it is, therefore, located in the right lower fourth of the abdomen. The appendix performs no useful digestive function, its chief importance arising from the fact that it occasionally becomes inflamed-appendicitis-and can pose a threat of serious and spreading infection within the abdomen.

Although appendicitis is generally regarded as a disease of children and young adults, it can occur in all age groups, including the elderly. Its symptoms may be deceptively mild, particularly at the beginning, and can easily be dismissed as -an upset stomach.” Typically, it starts with cramping abdominal pains experienced in the upper abdomen, generally above the level of the “belly button” (navel). There is usually an associated loss of appetite which may progress to nausea and occasionally to vomiting. Over the course of the next six to twelve hours there is increasing localization of pain in the abdominal region of the appendix.

The appendix is inches below and to the right of the navel. The pain here will be steady. and will increase if the patient coughs or is asked to “blow out” the abdomen. When the doctor makes his examination, he will look for such signs as:

1. Tenderness to pressure in the area,

2. Guarding-involuntary tightening up of the abdominal muscle overlying the inflamed appendix.

3. Rebound-the sudden sharp increase in pain produced %k hen manual pressure in this region is suddenly released.

There may not always be certainty in diagnosing acute appendicitis: among some of the conditions that imitate it are ovulation with the release of an egg and certain inflammations, generally viral, of the abdominal lymph glands. It may therefore be considered wise to hospitalize a suspected case of appendicitis for repeated blood cell counts and observations before the diagnosis can be established.

Treatment. There are no first-aid measures of any value in appendicitis, An icebag placed over the region may produce some relief of pain. Nothing should be given by mouth. Above all be sure to avoid the use of laxatives. It is a grievous error to mistake acute appendicitis as “gas pains” or “spastic constipation” and take a laxative, for this may produce rupture of the inflamed appendix and a spreading peritonitis. Clearly, both diagnosis and treatment require the skill of a doctor, who must check the patient. Remember that there are unusual cases of appendicitis in which the person feels “a little sick,” has a little soreness over the region of the appendix, and yet proves to have a severely inflamed appendix when surgery is performed. The degree of inflammation cannot be judged by fever; this seldom exceeds 100°F. by mouth throughout the early stages,