Sharp pain in the right side of the abdomen: when it comes to appendicitis?

Acute pain localized on the right side of the abdomen is one of the main reasons for patients to go to the emergency room. But when the pain is a symptom of the presence of appendicitis? Dr. Stefano Enrico explains it, expert in General Surgery and Colonproctology in Turin

What is appendicitis?

Acute appendicitis is usually caused by an infection of the appendix, that is, of that small worm-like component of the intestine connected with the blind that contains a large amount of lymphatic tissue. The appendix is ​​an organ highly prone to infections, as it is very sensitive to inflammatory phenomena. An appendicitis situation therefore occurs when the organ is affected by an infection also affecting the peritoneum area and the patient reports constant pain. Pain in the abdomenit occurs both spontaneously and on palpation and disorders such as fever, weakness and asthenia can also occur. The peristasis is also blocked, the intestinal loops of the area dilate and the hollow is closed with feces and gas. Other phenomena that can occur are then vomiting and the compromise of the general conditions. L ‘ appendicitis acute is more common in young people, in which can give episodes of severe pain, known as appendicular colic, even in the absence of infection, which usually regresses without any treatment.

Other causes of abdominal pain and differential diagnosis

The pain in the abdomen caused by some pathologies can remember very much that deriving from a situation of acute appendicitis. For this reason many people instantly associate the pain localized in this area with the appendix, when in reality the origin is another. Some of these abdominal pathologies are:

  • The diverticulitis acute, an infectious disease that affects the part of the colon called sigma, located in the left iliac fossa. However, when the section of the colon is particularly long, pain can also occur in the right side. To avoid confusion between the two pathologies it is advisable to carry out diagnostic tests such as ultrasound and CT;
  • Inflammatory bowel diseases such as Crohn’s disease, located in the ileocecal area. The clinical picture is very similar to that of severe acute appendicitis. The necessary diagnosis will then be made to clarify the origin of the disorder;
  • Meckel’s diverticulum, small in size and located in the middle of the ileum, can easily become inflamed and infected, creating a symptomatology very similar to that of appendicitis. An accurate diagnosis is possible only during surgery, when it is possible to see the state of the appendicitis and instead highlight the inflamed or infected diverticulum located a few centimeters higher, which will then be removed;
  • The renal colic , easier to differentiate but still capable of creating confusion in diagnosis because of the pain;
  • Gynecological pathologies, as uterus and related components, are located near the appendix. The most common pathologies are rupture of a follicular cyst during the ovulatory period, a condition of endometriosis, twisting of the ovary or female pelvic infections.

In conclusion

Pain in the vicinity of the right iliac fossa is very common and is characteristic of numerous pathologies and disorders, which pushes many patients to go to the emergency room as an emergency. Since the causes are vast, it is often difficult to make a certain diagnosis, which is therefore postponed during surgery. The surgery should begin with a diagnostic laparoscopy first , so that the peritoneal cavity can be examined directly and the most suitable type of surgical treatment will be chosen depending on the situation. Once the procedure has started, it is advisable to remove the appendix even if the problem was due to other reasons, except for specific contraindications

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