Appendicitis Evaluation & Treatment
Appendicitis is one of the most commonly treated conditions for a general or colorectal surgeon. The appendix is a tube shaped organ that is attached to the 1st portion of your colon which is also known as the cecum. It is thought that the appendix plays a role in our immune system when we are younger but it is not known to serve an important role for adults.
Appendicitis is the condition when your appendix becomes acutely inflamed. The cause of this is usually a small piece of stool that blocks the connection between the appendix and the colon. The symptoms of appendicitis are classically pain that starts near your belly button and radiates towards the right hip. However, there are additional signs and symptoms of appendicitis that you should be aware of. There can be associated nausea, vomiting, or a lack of appetite. Fever can happen as well, especially if the inflammation has been going on for several days. Some additional symptoms that can be related to appendicitis are pain in the right flank, pain with movement of your right leg, or foul-smelling/cloudy urine.
If you experience any of the signs or symptoms, it is best to be evaluated by your primary care physician, an emergency room provider or a general/colorectal surgeon. Typically, the workup will include some basic laboratory tests and either an ultrasound or CT scan of your abdomen. If your workup demonstrates acute appendicitis, the recommended treatment is surgical removal of your appendix, also known as an appendectomy. This is typically performed laparoscopically through small incisions and postsurgical recovery is fairly rapid. There are some centers that practice non operative management of appendicitis with antibiotics but the most effective way to deal with acute appendicitis in an otherwise healthy patient is with appendectomy.
Occasionally, patients will present with a perforated or ruptured appendix. This can result in an abscess formed around the appendix. Typically, this is managed with a drain placed by Interventional Radiology which will be followed by appendectomy in 1-2 months. Rarely, a patient can present with a freely ruptured appendix which can cause severe illness and require emergency surgery.
There are some other rare conditions that can mimic appendicitis. This include this certain tumors of the appendix which can have a similar appearance to appendicitis on CT scans. If you were found to have one of these lesions, it is best to be evaluated by a colorectal surgeon as the management can change from routine appendectomy.
Overall, appendicitis is a fairly common surgical condition and for the majority of patients, the treatment is straightforward with a short postoperative recovery.