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What is the appendix? — The appendix is a long, thin pouch that is shaped like a finger. It hangs down from the large intestine, which is also called the colon (figure 1).
What is appendicitis? — Appendicitis is the name for when the appendix gets infected and inflamed. If that happens, it can swell and in some cases burst. That's dangerous, because a burst appendix can cause infection in the belly.
What are the symptoms of appendicitis? — The usual symptoms include:
Severe pain in the lower part of the belly, on the right side. (For many people, the pain starts near the belly button and then moves to the lower right side.)
Loss of appetite
Nausea and vomiting
Some people can have different symptoms, such as:
Stomach upset
Having a lot of gas
Irregular bowel movements
Feeling ill
Is there a test for appendicitis? — If you have appendicitis, your doctor might be able to diagnose it just by doing an exam. He or she can learn a lot about your condition by pressing on your belly and talking with you about your symptoms. If your doctor is not certain after the exam, he or she can do tests to see what is causing your symptoms. Tests might include a CT scan, which is a special kind of X-ray.
Should I see a doctor or nurse? — Yes. Call your doctor or nurse right away if you have the symptoms listed above. The risk of your appendix bursting is much higher after the first 24 hours of symptoms. If the appendix bursts, the surgery to treat it will be more complicated.
How is appendicitis treated? — The main treatment for appendicitis is surgery to remove the appendix. This surgery can be done in 2 ways:
Open surgery – During an open surgery, the doctor makes a cut near the appendix that is big enough to pull the appendix through.
Laparoscopic surgery – During laparoscopic surgery, the doctor makes a few cuts that are much smaller than those used in open surgery. Then he or she inserts long, thin tools into the belly. One of the tools has a camera (called a "laparoscope") on the end, which sends pictures to a TV screen. The doctor can look at the image on the screen to know where to cut and what to remove. Then he or she uses the long tools to do the surgery.
If your appendix has burst, your surgery will probably be more complicated than it would be if it had not burst. Your doctor will need to wash away the material that spills out when an appendix bursts. As a result, your cuts might be larger or you might spend more time in surgery.
Can appendicitis be treated without surgery? — Yes. But your options will depend on whether or not your appendix has burst.
If your appendix has not burst, it's possible to treat appendicitis with just antibiotics. But, without surgery, there is a chance your appendicitis will come back again. So surgery is still the best treatment in most cases.
If your appendix has burst, but it has been a few days since this happened, your doctor might decide not to do surgery right away. That's because the body sometimes forms a pocket around the appendix to block off the infection. In this case, your doctor will probably give you antibiotics and watch you carefully until you are well. But you will still need surgery later to remove your appendix. That's because at least 1 in 10 people with a burst appendix have a tumor in their appendix that can only be removed by surgery.
What if I am pregnant? — If you are pregnant and think you have signs of appendicitis, make sure you tell your doctors that you are pregnant.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 15784 Version 11.0
Release: 28.2.2 - C28.105
© 2020 UpToDate, Inc. and/or its affiliates. All rights reserved.

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