The appendix is a small, tube-like organ attached to the first part of the large intestine. The appendix is located in the lower right part of the abdomen. Appendicitis is inflammation of the appendix.

Appendicitis can have more than one cause, and in many cases the cause is not clear. Possible causes include:

  • Blockage of the opening inside the appendix
  • Enlarged tissue in the wall of your appendix, caused by infection in the gastrointestinal tract or elsewhere in your body

The primary symptom of appendicitis is acute abdominal pain.  The pain begins near your belly button and then moves lower and to your right lower quadrant, gets worse in a matter of hours, gets worse when you move around, take deep breaths, cough, or sneeze, is severe and often described as different from any pain you’ve felt before, occurs suddenly and may even wake you up if you’re sleeping, and generally occurs before other symptoms.  Other potential symptoms include loss of appetite, nausea and vomiting.  You may have none or all the associated symptoms.  Diagnosis may be made just by the clinical presentation and examination, along with routine blood and urine tests.  If there is any question, a CT scan or ultrasound may be utilized.  If left untreated, there is a risk of perforation, with associated abscess or peritonitis.

Appendicitis is a surgical emergency generally treated with Laparoscopic Appendectomy, although rarely a formal incision to open the abdomen is required. During laparoscopic surgery, surgeons use several smaller incisions and special surgical tools that they feed through the incisions to remove your appendix. Laparoscopic surgery leads to fewer complications, such as hospital-related infections, and has a shorter recovery time.  After surgery, most patients completely recover from appendicitis and don’t need to make changes to their diet, exercise, or lifestyle. Surgeons recommend that you limit physical activity for the first 3 to 5 days after laparoscopic surgery. And 10 to 14 days after an open procedure.

In some cases, a surgeon finds a normal appendix during surgery. In this case, many surgeons will remove it to eliminate the future possibility of appendicitis. Sometimes surgeons find a different problem, which they may correct during surgery.

In some rare cases of mild appendicitis treatment may consist of antibiotics alone. These are highly selected cases meeting strict criteria.

Complications of appendicitis include perforation with either peritonitis (inflammation of the entire abdominal cavity) or abscess.  In most cases of peritonitis, a surgeon will remove your appendix immediately with surgery. The surgeon will to clean the inside of your abdomen to prevent infection and then remove your appendix. Without prompt treatment, peritonitis can cause death.

If an abscess forms, the surgeon may drain the pus from during surgery or before surgery. To drain an abscess, the surgeon places a tube in the abscess through the abdominal wall. You leave the drainage tube in place for about 2 weeks while you take antibiotics to treat infection. When the infection and inflammation are under control, about 6 to 8 weeks later, surgeons operate to remove what remains of the burst appendix.