Acute pain in the abdomen – Is it appendicitis?

Dr. Uday Singh Dadhwal of Bahrain Specialist Hospital tells us more..

Appendicitis is an inflammation of the appendix, a finger-shaped pouch that projects from your colon on the lower right side of your abdomen. Appendicitis is the most common medical emergency in the United States. More than 250,000 appendectomies are performed annually. Appendicitis occurs most often between the ages of 10 and 30 years. It is more common in men than in women. An untreated appendicitis can be fatal.

Why the appendix becomes inflamed

Scientists think this condition is caused by an obstruction in the appendix. Obstruction may be either partial or complete. Complete obstruction is cause for emergency surgery. When the appendix is obstructed, bacteria can multiply inside the organ. This leads to the formation of pus. The increased pressure can be painful. If the appendix ruptures, fecal matter can fill the abdomen. This is a medical emergency.

What are the symptoms of appendicitis?

Appendicitis pain may start off as mild cramping. It often becomes more steady and severe with time. You will not necessarily notice changes in your bowel habits. However, sometimes appendicitis can affect urination.

If you have right side tenderness along with any of these other symptoms, talk to a doctor. Appendicitis can quickly become a medical emergency. Rupture rarely happens within the first 24 hours of symptoms. A perforated appendix can be fatal. The risk of death is highest in infants and the elderly.

How do doctors diagnose appendicitis?

A physical exam for appendicitis is done to look for tenderness in the lower right quadrant of your abdomen. If you are pregnant, the pain may be at higher level. If perforation occurs, your abdomen may become hard and swollen.

In addition, your doctor will also perform several tests for appendicitis. Urinalysis can rule out a urinary tract infection or kidney stone. Pelvic exams can make certain that women don’t have reproductive problems. They can also rule out other pelvic infections. A pregnancy test can rule out a suspected ectopic pregnancy.

Abdominal imaging can determine if you have an abscess or other complications. This may be done with an X-ray, ultrasound, or CT scan. Chest x-ray can rule out right lower-lobe pneumonia. This sometimes has symptoms like appendicitis.

How is appendicitis treated?

In most cases, surgery will be necessary. The type of surgery will depend on the condition of the patient. In rare cases, mild appendicitis may get better without surgery. Treatment might involve only antibiotics and a liquid diet.

Surgery to remove the appendix is called an appendectomy. This procedure can be done as open surgery or laparoscopically. Laparoscopy is less invasive. Recovery time is shorter. However, open surgery may be necessary if you have an abscess or peritonitis. If you have an abscess that has not ruptured, you will first be treated with antibiotics. Your abscess will then be drained with a tube placed through your skin. Surgery at a later date will remove your appendix after your infection has been treated. If you have a ruptured abscess or appendix, surgery may be needed right away.

Dr. Uday Singh Dadhwal
(Specialist General Surgery)
Bahrain Specialist Hospital