Tuesday, May 11, 2010

How do I know if I have appendicitis?

I often see people who are very worried about appendicitis but have no symptoms that would suggest they have it.

Here's what makes me think you (or your child) might have appendicitis.

Appendicitis pain generally comes on slowly and starts in the middle of the abdomen then moves to the right lower quadrant (think of your abdomen divided into 4 parts- the lower right is the right lower quadrant). There is usually a fever, there may be some diarrhea. The patient is not hungry and may feel bloated. It is usually painful for the patient to move around, especially to jump up and down. When the right lower quadrant is pressed, the is pain and it is often worse when the person pressing releases the pressure (this is called rebound tenderness).

Constipation may also look like appendicitis. If we suspect appendicitis we will hold on all food and put in an IV. We will draw blood to look at the white blood cell count which is an indicator of infection. We may order a CT scan of the abdomen (sometimes we do ultrasounds in kids).

Appendicitis can sometimes be difficult to diagnose. If we have a high enough suspicion then the patient may be admitted to the hospital to be watched carefully. The pain may change or get worse then the diagnosis becomes more obvious.

The treatment for appendicitis is surgery. It is an urgent surgery, meaning it needs to be done as soon as possible but not necessarily right that very second. Sometimes it may be necessary to wait a few hours and that is usually ok.
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