Appendicitis
Appendicitis is a condition characterized by inflammation of the appendix of the large intestine.
Untreated, mortality is high, mainly because of the high likelihood of rupture and subsequent peritonitis, shock, and death.
The inner lining of the appendix produces mucus that flows through the open center (lumen) of the appendix and into the cecum (the beginning end of the large intestine). Additionally, the wall of the appendix contains lymphatic tissue that is part of the immune system (the body's defense system).
Acute appendicitis has historically thought to result from the primary obstruction of the appendix lumen, causing the appendix to become filled with mucus. Consequently, the increasing pressures within the lumen and the walls of the appendix from the accumulation of mucus result in thrombosis and occlusion of the small blood vessels and blockage of lymphatic flow. As this occlusion progresses, the appendix becomes ischemic and then necrotic (the cells and living tissue die). As bacteria in the lumen of the appendix begin to leak out through the dying walls, pus forms within and around the appendix (suppuration). As a result the appendix will eventually burst, or perforate, spilling infectious materials into the abdominal cavity causing peritonitis (inflammation of the peritoneum or the membrane which lines part of the abdominal cavity and some of the abdominal organs), septicemia (the presence of pathogenic organisms in the blood-stream), and eventually death.
Alternatively, the inflamed appendix can be walled off from the rest of the body by the production of scar tissue forming a peri-appendiceal abscess that prevents the infection from spreading. This abscess can occasionally heal eventually leaving a mass of scar tissue.
Alternatively, experimental data suggest that obstruction is not an important factor in the causation of acute appendicitis, but may develop as a result of the inflammatory process. Needless to say, there is no clear answer, and there are multiple ways appendicitis can develop.
Appendicitis typically begins with a vague pain in the middle of the abdomen around the "belly button" (periumbilicus), and over the next 24 hours slowly moves to the right lower abdomen.
In addition, the appendix can lie in various positions adding to the variability of pain localization and subsequent surgical treatment.
Classically, the abdominal pain is accompanied with nausea, vomiting, decreased or absent appetite, and fever; however, people with appendicitis usually do NOT have all of these symptoms.
1 in 15 people in the United States get appendicitis, and although it can strike at any age, appendicitis is most common between ages 10 and 30.
If you believe you are having appendicitis, then go to the nearest emergency room.
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