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Appendicitis Fact: An
appendicitis is defined as an inflammation of the appendix, an organ
located in the right lower quadrant of the abdomen. Acute
appendicitis attacks are usually marked by nausea, vomiting, and
intense pain with movement, as well as tenderness in the right lower
quadrant of the abdomen.
Appendicitis is a condition characterized by inflammation of the appendix. It is classified as a medical
emergency and many cases require removal of the inflamed appendix, either by laparotomy or laparoscopy.
Untreated, mortality is high, mainly because of peritonitis and shock. Reginald Fitz first described
acute and chronic appendicitis in 1886, and it has been recognized as one of the most common causes
of severe acute abdominal pain worldwide. A correctly diagnosed non-acute form of appendicitis is known
as "rumbling appendicitis".
The term "pseudoappendicitis" is used to describe a condition mimicking appendicitis. It can be associated
with Yersinia enterocolitica.
Signs and Symptoms
For the most part symptoms relate to disturbed function of bowels. Pain first, vomiting next and fever last
has been described as classic presentation of acute appendicitis. Pain starts mid abdomen, and except in
children below 3 years, tends to localize in right iliac fossa in a few hours. This pain can be elicited
through various signs. Signs include localized findings in the right iliac fossa. The abdominal wall becomes
very sensitive to gentle pressure (palpation). Also, there is severe pain on suddenly releasing a deep
pressure in lower abdomen rebound tenderness. In case of a retrocecal appendix, however, even deep pressure
in the right lower quadrant may fail to elicit tenderness (silent appendix), the reason being that the
cecum, distended with gas, prevents the pressure exerted by the palpating hand from reaching the inflamed
appendix. Similarly, if the appendix lies entirely within the pelvis, there is usually complete absence
of the abdominal rigidity. In such cases, a digital rectal examination elicits tenderness in the
rectovesical pouch. Coughing causes point tenderness in this area (McBurney's point) and this is the
least painful way to localize the inflamed appendix. If the abdomen on palpation is also involuntarily
guarded (rigid), there should be a strong suspicion of peritonitis requiring urgent surgical intervention.
Appendicitis - information on signs and symptoms provided by
Appendicitis - informative eMedicine article with signs,
symptoms, etiology, frequency, etc.
Acute Appendicitis - excerpt from the Merck Manual
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