Patient Information Series 

What is appendicitis?

This is inflammation of the appendix. The appendix is an intestinal appendage situated usually in the right lower abdomen at the junction of the small and large intestines.

What causes appendicitis?

Most instances are thought to result from some obstruction to the appendix lumen that interferes with the blood supply  setting up a bacterial infection.

What are the symptoms?

Classically starts as intermittent pain around the umbilicus (belly button) which moves to the right lower abdomen becoming more constant.

Other symptoms that may occur include nausea, vomiting, fever and diarrhoea.

How is the diagnosis made?

The doctor makes the diagnosis by examination of the patient. It is usually a clinical diagnosis since no investigation can reliably exclude other conditions especially in female patients where gynaecological problems can mimic appendicitis. Laparoscopy (key-hole surgery) is useful in such doubtful cases.

What is the treatment?

Acute appendicitis is treated by an operation to remove the inflamed appendix (appendicectomy). This can be done by open or keyhole method usually with a general anaesthetic.

What are the complications of appendicitis?

Gangrene of the appendix can occur resulting in an abscess locally in the right lower abdomen or peritonitis when the abscess disseminates throughout the abdomen.

What are the complications of appendicectomy?

There is potential for wound infection since the inflammation involves bowel organisms. The incidence is reduced by the use of antibiotics around the time of surgery.

Wound infection is treated with antibiotics in the early stages when the wound is inflamed. An established wound abscess would require surgical drainage.