How to recognize appendicitis? What symptoms does it have?

Apart from its ability to become infected and torment a child or adult, the appendix has a more significant nature.

Symptoms of appendicitis can be typical, but also atypical and unremarkable. Recognising appendicitis in the case of typical symptoms is not that difficult.

Treatment of appendicitis can be conservative or surgical. It all depends on several circumstances.

And this is how you can recognize appendicitis...

Appendicitis

The appendix vermiformis (wormy process), as it is professionally called, is a blindly terminated process at the beginning of the large intestine (intestinum caecum, appendix).

It is 5-10 cm long (sometimes 2-20 cm) and 7-8 mm in diameter.

Its importance is not entirely negligible, as it might seem at first sight and as our parents once told us.

The longest appendix was removed in Zagreb, Croatia, and was 26 cm long.

Don't underestimate the importance of the appendix

The appendix is not just an insignificant protrusion at the beginning of the colon.

It is important in several ways. One of them is that it contains beneficial intestinal microflora.

It is important for immunity and the lymphatic system. In 2007, this idea was put forward by William Parker and Randy Bollinger, colleagues at Duke University in the USA.

Inflammation of the appendix

Appendicitis, or inflammation of the appendix, is the most common inflammation in the abdominal cavity. It is one of the most common sudden abdominal events.

The symptoms of appendicitis are influenced by the location of the appendix, which can vary from person to person, and its length.

The inflammation can be mild, chronic.

After conservative treatment, the symptoms calm down, but may return. Conservative treatment has advantages over surgery, mainly in that the appendix is preserved and can continue to perform its beneficial role for the body.

The worse case is the acute course, when the inflammation spreads throughout the thickness of the appendix wall and phlegmonous appendicitis develops. Eventually it progresses to gangrenous inflammation, which is actually the death (necrosis) of the appendix.

The most serious complication is rupture (perforation) of the appendix. This is when the intestinal contents spill into the abdominal cavity.

Peritonitis and its associated serious complications occur. Appendicitis complicated in this way can end in death.

It is therefore important to seek medical treatment as soon as possible when acute intense complaints resembling appendicitis occur. In these cases, treatment is surgical.

How does appendicitis manifest itself?

As already mentioned, the manifestations can be typical, but also atypical, based on its location in the abdominal cavity. It can even mimic the symptoms of other diseases of the digestive system. Therefore, with any abdominal pain, it is necessary to think about appendicitis.

The main typical symptoms include:

• abdominal pain
  • starts in the navel area
  • after a few hours it moves to the right lower quadrant of the abdomen
  • aggravated by movement, coughing, sneezing, deep breathing
• distaste
• nausea
• nausea - feeling nauseous to vomiting
• bloating
• stopped winds
• constipation or diarrhoea
• rapid pulse
• pallor
• sweating
• rapid breathing
• hardening of the abdominal muscles at the site of inflammation
• increased body temperature up to 38 °C, later fever
  • the difference between the measured body temperature in the armpit and in the rectum may be up to 1 °C
    • axillorectal temperature difference, Lennander's sign

In the elderly, the symptoms may be subtle and easily missed.
Similarly in newborns and toddlers - then the symptoms of febrile illness are present.

How else to recognize appendicitis?

In addition to the symptoms mentioned above, appendicitis can be recognized by auxiliary examinations. Any abdominal pain with associated symptoms should, of course, be examined by a doctor. Abdominal pain tends to be a symptom of minor but also serious diseases. It is not good to neglect it.

The doctor can add other examinations that will help to reveal the cause. The first thing to be done is an ultrasound (sonography), CT scan or X-ray.

Additional examinations without aids:

• Zelenka's sign - In the initial phase, when pushing in the right lower abdomen, the pain in the navel area or above it is accentuated
• Plenies sign - Pain when tapping on the right lower abdomen
• Blumberg's sign - When the right lower abdominal area is pressed and released, pain is accentuated
• Rovsing's sign - Squeezing the left lower abdomen causes pain in the right lower abdomen

In some cases, the obturator and psoas signs may be present. They are detected with certain movements of the lower limb.

If you have any doubts or questions, you can contact your general practitioner or a doctor specialising in surgery. They will then refer you for further investigations to help identify the causes of your abdominal pain. There may be several. As you have already read, appendicitis is one of the most common causes.