Acute appendicitis is the sudden and severe inflammation of the appendix. It can cause pain in the abdomen, and this pain may occur quickly and worsen within hours.

The appendix is a narrow tube that attaches to the large intestine. It is located in the lower righthand side of the abdomen.

Any blockage or inflammation affecting the appendix can lead to swelling, causing acute appendicitis.

This article will look at the causes, symptoms, treatment options, and recovery details associated with acute appendicitis.

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Acute appendicitis is a medical emergency. People will need immediate medical care if they have any symptoms of appendicitis.

Without treatment, the appendix can rupture or burst within 48–72 hours of a person first experiencing symptoms of acute appendicitis. A ruptured or burst appendix can lead to a serious infection called peritonitis, which can be life threatening without prompt treatment.

The symptoms of acute appendicitis occur suddenly and are usually severe. They may worsen over the course of a few hours.

It is best to avoid taking any pain relief medication for symptoms of acute appendicitis, as this could mask symptoms that a doctor will need to know about.

In adults

Symptoms of acute appendicitis in adults can include:

  • pain around the belly button, which may move to the lower righthand side of the abdomen
  • a swollen abdomen
  • vomiting
  • loss of appetite
  • fever and chills
  • constipation or diarrhea
  • difficulty passing gas

The pain may worsen over time or with movement, deep breaths, coughing, sneezing, or touching the abdomen.

If the appendix bursts, a person may feel pain across the whole of the abdomen.

In children

Children may experience the following symptoms of acute appendicitis:

  • general discomfort or malaise
  • loss of appetite
  • abdominal pain, which may move to the lower righthand side of the abdomen
  • nausea and vomiting
  • low grade fever
  • an increased heart rate

Acute appendicitis occurs when something blocks the inside of the appendix. This could be due to:

  • a viral, bacterial, or parasitic infection in the digestive tract, which can enlarge the tissue of the appendix wall
  • stools causing a blockage in the tube between the large intestine and the appendix
  • tumors
  • inflammatory bowel disease
  • injury or trauma to the abdomen

This results in the appendix becoming swollen and inflamed.

According to Johns Hopkins, as the swelling increases, the blood supply to the appendix reduces and stops. Without enough blood, the appendix may start to die, or it could tear or burst.

For acute appendicitis, people will need immediate surgery to remove the appendix. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) notes that receiving immediate treatment reduces the risk of the appendix bursting.

There are two types of surgery to remove the appendix: laparoscopic surgery and laparotomy surgery.

In laparoscopic surgery, a surgeon will make several small cuts in the abdomen to remove the appendix. In laparotomy surgery, they will make a single cut in the lower righthand side of the abdomen to remove the appendix.

If the appendix has burst, it could cause a serious infection within the lining of the abdominal wall. The surgeon will remove the appendix with surgery and clean the inner abdomen to prevent any infections.

Is surgery necessary?

In some cases, antibiotics may be enough to cure mild cases of acute appendicitis. A doctor will prescribe antibiotics to anyone who may have appendicitis.

According to the NIDDK, laparoscopic surgery has a lower risk of complications and a quicker recovery time than laparotomy surgery.

People will need to limit their physical activity for 3–5 days after laparoscopic surgery or for 10–14 days after laparotomy surgery.

To diagnose acute appendicitis, a doctor will take a medical history and carry out a physical examination. They may also perform the following:

  • a blood test to check for a high white blood cell count, which can signal infection
  • a urine test to check for urinary tract infections
  • an abdominal ultrasound to check how the internal organs are working and to monitor blood flow
  • a CT scan to produce a detailed image of the inside of the body
  • an MRI scan, which a doctor may use instead of a CT scan if the person is pregnant

Without prompt treatment, acute appendicitis can cause the appendix to burst. This can lead to a condition called peritonitis.

Symptoms of peritonitis include:

  • nausea
  • fever
  • vomiting
  • severe tenderness in the abdomen

Peritonitis is a serious infection that can be life threatening without immediate treatment. To treat peritonitis, a surgeon will remove the appendix and clean the inside of the abdomen.

The NIDDK notes that untreated acute appendicitis can also lead to an appendiceal abscess. If this occurs, the surgeon will drain the abscess before or during surgery.

To do this, they will place a drainage tube into the abscess, and the person will need to leave this tube in for 2 weeks while taking antibiotics. After 6–8 weeks, the surgeon will remove the rest of the appendix.

Receiving immediate surgery can treat acute appendicitis. Most people make a full recovery after surgery for appendicitis.

People will not need to make any changes to their diet or lifestyle after surgery, and most people are able to live healthy lives without their appendix.

According to one 2015 case report, chronic appendicitis is a rare and less severe type of appendicitis.

With chronic appendicitis, a person may experience continuous abdominal pain that may last for weeks, months, or years. This pain can range from mild to moderate. A fever may also be present.

Researchers do not know the exact cause of chronic appendicitis. However, it may result from a partial and consistent blockage in the appendix.

Chronic appendicitis is not a medical emergency. However, without a diagnosis, chronic appendicitis could lead to serious complications.

Learn more about chronic appendicitis here.

Acute appendicitis refers to the sudden and severe inflammation of the appendix. Acute appendicitis is a medical emergency, and people will need medical care straight away.

People will usually need to undergo surgery to remove the appendix. Receiving prompt treatment can help prevent the appendix from bursting. A burst appendix is a serious complication. It can cause a dangerous infection and will need immediate treatment.

Most people will make a full recovery from appendicitis and can live normal, healthy lives without their appendix.