Appendicitis is a medical condition characterized by Inflammation of the appendix.
Appendix is the extension of an organ. In human body, there are several appendices:
Xiphoid appendix – it is located at the lower end of the sternum, bone located at the front of the thorax and on which the ribs are linked through the costosternal cartilage.
Epiploic appendix – they are small sacs of peritoneum filled with fat that extend the colon and upper part of the rectum.
Vermiform appendix, commonly called appendix, is the most common. It starts below the ileocecal valve to the point of junction between the small intestine and the colon. Cylindrical shaped, it measures 7 to 10 inches long and 4 to 8 mm in diameter.
Appendicitis Causes and Risk Factors
Appendicitis can occur at any age, but it is particularly common among adolescents, women, and young adults under 30. Sometimes, origin of the inflammation is unknown; however, in most cases, it is caused by the obstruction of the appendix due to an accumulation of feces, or a simple catarrhal (inflammation of a mucous). When the obstruction occurs, the appendix becomes swollen and filled with pus, which increases pressures within its walls, resulting in thrombosis (formation of a blood clot in a blood vessel) of the small vessels.
An obstruction may also occur if the lymph nodes of the appendix are swollen. Some other less common causes of the blockage are residues of seeds of fruits and vegetables, intestinal worms, thickening of barium caused by previous exposure to X-ray, and tumor or colon cancer.
The symptoms of the disease may vary depending on its location in the body. When the appendix is normally located, appendicitis is characterized by a severe pain in the iliac fossa (inner abdominal area occupying the lower and lateral surface of the ilium) accompanied with nausea or vomiting, and a mild fever (38 ° C to 38.5 ° C). Palpitation of the area is painful and causes a defensive reaction (hardening of the abdominal wall). In most people, transit of stool becomes slowed or blocked.
When the appendix is found behind the cecum (a sac that forms the first part of the large intestine), the inflammation leads to back pain. In women, located in lower side of the belly, it is characterized by symptoms similar to those of inflammation of the fallopian tubes. When it is located under the liver, it tends to cause an acute gallbladder infection.
The diagnosis is more difficult to establish when the appendix is abnormally located. X-ray examination is not reliable enough to detect the obstruction with certainty. The physician may proceed to ultrasound and abdomen scanner to confirm the result of the X-ray. Without specific medical tests, no physician can rely on the symptoms above to declare appendicitis. Many diseases have also signs close to those of appendicitis: urinary tract infection, vaginal infection in women, colitis, ileo-caecal tumor, mesenteric adenolymphoma (inflammation of the mesenteric lymph nodes) in children or vague abdominal pain without determined cause.
The only treatment of appendicitis is appendicectomy, surgical removal of the ileocecal appendix. The surgery must be decided only after reliable tests and on evident signs: abdominal defensive reaction, elevated white blood cells count, fever to around 38 °C, etc