Appendicitis

Appendicitis is an inflammation of the vermiform appendage (appendix) of the caecum. Appendicitis usually becomes acute within several hours and requires immediate surgery in most cases. Chronic or subacute appendicitis can also be treated with antibiotics.

The caecum is located in the right side of the lower abdomen. It forms a 6- to 12-cm-long intestinal loop at the beginning of the intestine which ends blind in the appendix. Food or faecal waste and bacteria can collect in the appendix. This contributes to the occurrence of inflammation. Appendicitis is therefore one of the most common intestinal inflammations. It can occur at any age; however, the frequency peak is in adolescence and young adulthood.

No clear cause can usually be found for appendicitis. It is assumed that food waste or stool particles have relocated to the appendix. Sometimes the blame for removing the appendix is placed on fruit stones, such as cherry stones, for example.

Acute inflammation of the appendix usually begins with a feeling of discomfort and diffuse stomach pain. The pain typically concentrates quickly in the right lower abdomen and can be very severe. Coughing or tension in the abdominal wall intensifies the pain even more. Besides pain, nausea, constipation or fever can also occur.

Although appendicitis usually occurs in an acute form, there are also chronic courses. If the appendicitis is chronic, the symptoms are less pronounced and the inflammation may spontaneously subside once again.

Acute appendicitis is diagnosed on the basis of the characteristic symptoms. An examination of the blood and an ultrasound examination can provide further indications of appendicitis. If there is a sufficiently high likelihood of appendicitis, the patient usually undergoes surgery very quickly. If the surgery is put off for too long, there is a risk that the inflammation will rupture and develop into life-threatening peritonitis. Find out more about the surgery in the appendix surgery section.

If the appendicitis is chronic or subacute, antibiotic treatment can also be carried out instead of surgery. If such chronic inflammatory phases occur repeatedly, operative removal of the appendix is usually also indicated.