Appendicitis is inflammation of the appendix, a small pouch connected to the beginning of the large intestine. It commonly causes worsening abdominal pain and can lead to a burst appendix, infection throughout the abdomen, or a pocket of infection if treatment is delayed.
Suspected appendicitis needs prompt medical evaluation.
Go to an emergency department for significant or worsening right-lower abdominal pain, repeated vomiting, fever, fainting, a rigid or very tender abdomen, or rapidly worsening symptoms. Do not wait for a routine office appointment.
What symptoms can appendicitis cause?
A common pattern begins with vague discomfort near the belly button that later moves to the right lower abdomen. Loss of appetite, nausea, vomiting, and fever may occur. Some people have constipation or diarrhea. The pattern can be less typical in children, older adults, pregnant patients, and people whose appendix sits in an unusual position.
No symptom proves appendicitis by itself. Kidney stones, urinary infections, intestinal conditions, gynecologic problems, and other illnesses can cause similar pain.
How is appendicitis diagnosed?
Clinicians combine the history, an abdominal examination, blood and urine tests, and imaging when appropriate. Ultrasound may be used first in some patients. A CT scan or MRI can provide more detail when the diagnosis is uncertain or another cause of pain is possible.
Does appendicitis always require surgery?
Surgical removal of the appendix, called an appendectomy, remains the standard treatment and is recommended for many patients. Selected uncomplicated cases may sometimes be treated first with antibiotics after a careful discussion of the chance that treatment will not work, the possibility that appendicitis will return, access to follow-up, and patient preference.
A burst appendix, widespread infection, or an abscess requires an individualized plan. Treatment may include antibiotics, drainage of an abscess, surgery, or procedures performed at different times depending on the patient's condition.
How is an appendectomy performed?
Most appendectomies are performed under general anesthesia through several small incisions with a camera. An open operation through one larger incision may be safer when inflammation is extensive, anatomy is difficult to see, scar tissue is dense, or another problem is found. The removed appendix is sent for examination by a pathologist.
What does recovery involve?
Recovery depends on whether the appendix had burst, whether an abscess or widespread infection was present, and whether the operation was performed through small incisions or an open incision. The treating surgical team should provide specific instructions about wound care, diet, activity, pain control, and warning signs.
After treatment, contact the treating team for increasing pain, persistent vomiting, a swollen abdomen, fever, wound redness or drainage, or difficulty eating and drinking.
Want a more detailed explanation?
Read the full patient guide to appendicitis symptoms, diagnosis, and treatment.