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Pain with Appendicitis and its Symptoms
Appendicitis can affect all age groups from infants to adults. It has been known to be one of the most common (nonpregnancy related) surgical emergencies in the pregnant female. The common presentation is one of diffuse abdominal pain with fever, loss of appetite, and nausea. Within hours (6-8 hours) the pain localizes to the right lower quadrant of the abdomen (right upper quadrant in the pregnant female).Tenderness to palpation (pushing down) of this area represents the most consistent finding. Evaluation by the physician will include detailed history for the common symptoms of loss of appetite, nausea, abdominal pain, and fever. A physical examination will usually show low grade fever and right lower quadrant abdominal tenderness. If the evaluation involves a female of reproductive age, a pelvic exam to exclude pelvic inflammatory disease, or tubal pregnancy is necessary. Blood pregnancy testing will be necessary in these cases. Blood tests for complete blood count should be done to detect an elevated white blood cell count. Urinalysis can help exclude the possibility of a urinary tract infection, which can be confused with this problem. X-rays of the abdomen will be done in most cases (although usually normal in appendicitis). Treatment involves 24 hour inpatient observation for questionable cases and surgery for suspected cases. Delay in surgery can result in the complication of "ruptured appendix". In this instance, the bacterial infection is free to spread throughout the abdominal cavity resulting in a life threatening condition known as peritonitis. Rupturing of the appendix will result in increased mortality and morbidity (prolonged recovery period). It is a known fact that 22-24% of cases involving appendectomy (appendix removal) result in the removal of a "normal" appendix. It has been shown that this statistic is consistent and necessary. If ONLY patients with TRUE appendicitis were operated on, doctors would be missing the disease in a large portion of the patients with the signs and symptoms of appendicitis. A General Surgeon is expert in the case management of acute appendicitis.
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