– An acute inflammation of the appendix.
Causes and Incidence
The etiology is not clear but appears to be related to obstruction of the appendiceal lumen by a fecal mass, stricture, or infection. Acute appendicitis is one of the most common reasons for abdominal surgery. The incidence is about 1 in 1,000 persons in the United States; the condition is most common in adolescents and young adults and is slightly more prevalent in men.
The lumen is obstructed, blood flow is diminished, hypoxia develops, the mucosa ulcerates, and bacteria invade the wall, causing an infection and producing edema, which further impedes blood flow, causing tissue necrosis, gangrene, and perforation.
The typical symptom is progressively severe abdominal pain, which begins in the midabdomen and shifts to the lower right quadrant after 6 to 10 hours. The pain may be accompanied by a low-grade fever, malaise, nausea, and vomiting.
Perforation causes peritonitis.
Localized rebound tenderness at McBurney’s point.
Moderately elevated with left shift.
For visualization when diagnosis is in doubt.
Surgery – Appendectomy.
Drugs – Antibiotics for prophylaxis after surgery.
General – None.