Diagnosis of Appendicitis

Diagnosis of Appendicitis

Elevated temperature and moderate to severe tenderness in the right lower abdomen suggests the diagnosis of acute appendicitis. If inflammation has spread to the peritoneum, rebound tenderness is present. This means that when the doctor pushes the abdomen and then releases his hand, the pain worsens transiently. 

Blood tests are recommended to check for a high white blood cell count, which indicate an infection. A urinalysis is advised to make sure that a urinary tract infection or a kidney stone is not responsible for pain. Abdominal X-ray or ultrasound scan may be done to confirm appendicitis or to look for other causes for the pain. Rarely a CT Scan also may be done if there is problem in diagnosis. However, these tests can be normal in the presence of appendicitis. 

What Other Conditions Can Mimic Appendicitis /Other conditions that can mimic appendicitis are : 

Meckel's diverticulitis : A Meckel's diverticulum is a small 'outpouching of the small intestine which usually is located in the right lower abdomen near the appendix. The diverticulum may become inflamed or even perforate. 
Pelvic inflammatory disease (PID): In females, the right fallopian tube and ovary lie near the appendix and if they get inflamed, they may produce signs and symptoms suggestive of appendicitis. 

Right-sided diverticulitis : Although most diverticuli are located on the left side of the colon, they occasionally occur on the right side. When a right-sided diverticulum ruptures it can provoke inflammation that mimics appendicitis. 
Kidney stone : A stone in the right kidney or right ureter can mimic appendicitis. 

Complications of Appendicitis

The most frequent complication of appendicitis is perforation. Perforation of the appendix can lead to a peri-appendiceal abscess ( a collection of pus around the appendix) or diffuse peritonitis ( infection of the entire lining of the abdomen and the pelvis).

Treatment of Appendicitis

Once a diagnosis of appendicitis is made, an appendectomy usually is performed. Antibiotics almost always are begun prior to surgery and as soon as appendicitis is suspected. 

There is small group of patients in whom the inflammation and infection of appendicitis remain mild and localized to a small area. This type of appendicitis can be treated with antibiotics alone. The appendix can then be removed at a later time. 

Appendectomy is the surgical removal of appendix. This can be performed by traditional open surgery, using a long abdominal incision, or by laparoscopic surgery, which requires only a few small abdominal incisions. In a laparoscopic procedure, the surgeon inserts a laparoscope - a pencil-thin tube with its own lighting system and miniature video camera - into the abdomen. Only a small incision is needed Then with the help of tiny instruments inserted through one or two other small abdominal incisions, the appendix is removed. Laparoscopic surgery allows faster recovery and healing with less scarring.

Appendicitis
Diagnosis of Appendicitis