At first Miguel thought he had a "stomach virus" or gastrointestinal infection. His stomach hurt and he was throwing up. He wasn't hungry at all. But the next day, instead of feeling better, he felt worse. In addition to his other symptoms, he had a fever. Miguel's dad called the doctor, who asked them to come in right away. After examining Miguel, the doctor said they had done the right thing by calling because Miguel, as it turned out, had appendicitis and needed surgery.
What Is Appendicitis?
Appendicitis is an inflammation of the appendix. The appendix is a tubular shaped piece of tissue, the size of a finger, that connects to the large intestine at the lower right side of the abdomen. The inside of the appendix forms a pouch that opens to the large intestine.
Appendicitis can occur when the opening of the appendix to the large intestine gets blocked. Blockage can be due to hard rock-like stool, inflammation of lymph nodes in the intestines, or even parasites. Once the appendix is blocked, it becomes inflamed and bacteria can overgrow in it.
If the infected appendix is not removed, it can eventually burst or rupture from the buildup of pressure. This may happen as soon as 48 to 72 hours after symptoms start. The infection from a ruptured appendix is very serious — it can form an abscess (a walled-off infection of pus) or spread throughout the abdomen.
Symptoms of Appendicitis
The classic symptoms of appendicitis are abdominal pain and loss of appetite. Abdominal pain usually begins in the center of the abdomen, around the area of the navel. Later, the pain may move downward and to the right, to an area called McBurney's point, which roughly corresponds to the location of the appendix.
After abdominal pain begins, a person with appendicitis may develop a slight fever, have a loss of appetite, feel nauseated, or vomit. The pain from appendicitis can become steadily worse. If appendicitis isn't treated promptly, the infected appendix may rupture and the infection may spread to other areas of the abdomen and cause pain over the whole abdomen.
Of course, some of the symptoms of appendicitis can occur in a variety of illnesses. That's why it's important that you call your doctor to help make a diagnosis.
Development and Duration of Appendicitis
There is no specific incubation period (the time it takes for symptoms to develop) for appendicitis. Once the appendicitis symptoms appear, it can take as little as 48 to 72 hours for the infected appendix to rupture. If the appendix ruptures, the infection will likely spread to other areas of the abdomen, increasing the risk of serious complications and making treatment more difficult.
When to Call the Doctor
If you suspect that you have appendicitis, call a doctor immediately. Appendicitis is an emergency that must be treated surgically. It can't be treated at home.
To help make a diagnosis, your doctor will ask you about your medical history and perform a physical exam. The doctor will usually do some blood tests and may recommend X-rays, a CAT scan, or an ultrasound examination. The doctor will decide whether you need surgery.
Ask before taking any pain medications (such as acetaminophen or ibuprofen) because your doctor will need to examine your abdomen for signs of pain and tenderness. Don't take laxatives or use enemas until your doctor sees you because these can cause the appendix to rupture.
Also, if your doctor suspects you have appendicitis, you will probably be asked to stop eating or drinking (an important precaution when a person is possibly going to have surgery).
Treating Appendicitis
Appendicitis is treated with surgery to remove the infected appendix. The operation is called an appendectomy. To prepare for the surgery a person will receive anesthesia. Anesthesia puts a person in a deep sleep and prevents pain.
An appendectomy generally has few complications, with a hospital stay of 1 to 3 days. However, if the infected appendix ruptures before surgery, the person usually stays in the hospital longer to receive antibiotics that will help kill bacteria that may have spread to the abdominal cavity. Even if the appendix has not ruptured, the doctor may prescribe antibiotics because they can decrease the risk of infection after surgery.
After a few days of rest at home, a student can safely return to school.
If You Think You Have Appendicitis
The best thing you can do is to get help from your doctor right away if you suspect that you have appendicitis. Prompt treatment of appendicitis usually prevents complications and gets you back to your regular routine faster.
Reviewed by: Yamini Durani, MD
Date reviewed: May 2007
Originally reviewed by: Philip Wolfson, MD
