Appendicitis is the acute inflammation of the appendix , a small organ that extends from the intestine to the caecum, usually located in the lower right part of the abdomen. Its exact role is unknown, but it is thought to play an important role in protecting the intestine from infection . It is also considered a process of involution of the intestinal sac in herbivores.
Appendicitis is a very common infection that can occur at any age but is more common in young people. If not treated properly, this condition can become complicated and progress to perforation, leading to peritonitis. It’s important to understand the symptoms well so you can intervene before serious complications arise.
What are the symptoms of appendicitis and how is it treated? We discuss this with Dr. Marco Platto , General Surgeon at Humanitas Mater Domini (Castellanza – Varese) and the Humanitas Medical Care medical centers .
What causes appendicitis?
The most important determining factor is obstruction of the organ’s lumen , caused by a foreign body (femoral lith) and, more rarely, by angulation or torsion of the viscus. The creation of a closed chamber favors bacterial multiplication, while the increase in intraluminal pressure causes stasis and, subsequently, ischemia, creating a favorable environment for bacterial invasion of the wall.
Appendicitis: the symptoms
The symptoms of appendicitis are:
- Abdominal pain : usually with complete well-being, sometimes following a one- or two-day prodromal period of dyspeptic symptoms (loss of appetite, headache, nausea). Subsequently, the patient is initially struck by colicky pain, then becomes constant, localized in the lower right abdomen (right iliac fossa), sometimes radiating to the homolateral thigh and lumbar region.
- Nausea and vomiting .
- Fever (38-38.5°C).
- Progressive closure of the bowel , first to feces and then to gas.
Appendicitis: tests for diagnosis
The diagnosis is initially clinical: the location of the pain, muscle contracture during the evaluation, nausea and vomiting associated with alterations in blood tests with an increase in the white blood cell count (leukocytosis) and C-reactive protein (CRP).
Diagnosis may be difficult if the location of the appendix is not typical but is located behind the colon (retrocecal) or behind the liver (subhepatic).
For a correct diagnostic assessment, an abdominal ultrasound may be performed and, at a later stage, an abdominal CT scan .
Appendicitis: When is surgery necessary?
Treatment, in mild and initial forms, can be carried out with broad-spectrum antibiotic therapy.
In most cases, appendectomy surgery is necessary . The surgery is performed through three incisions: one supraumbilical, one on the left flank, and one suprapubic. With these three incisions, the appendix is sectioned at its base and removed.
In the most severe cases, although increasingly rare, laparoscopic surgery must be interrupted and a classic abdominal incision must be made.
Minimally invasive access allows for faster recovery times and the patient can return home within 24-48 hours.
Can appendicitis be prevented?
Appendicitis cannot be prevented, but a healthy lifestyle , including regular physical activity and a diet rich in fiber , helps maintain a normal body weight and reduce the risk.
Furthermore, chewing food slowly and thoroughly aids digestion and can help the intestines function better, reducing the risk of conditions like constipation . Constipation can lead to the formation of small, hard stool masses (fecal stones), which sometimes cause appendicitis.
